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General NPI Number Information
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NPI Number | 1831750694
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC ELEVATED PLLC
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 06/24/2019
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Provider Practice Location Address
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Address Line | 101 LANG BLVD
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City | GRAND ISLAND
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State | NY
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Zip | 14072-1601
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Country | US
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Telephone | 716-799-4582
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Fax | 716-774-8004
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Provider Business Mailing Address
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Address Line | 1291 93RD ST
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-2607
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Country | US
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Telephone | 716-799-4582
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Fax | 716-774-8004
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL J. CALARCO
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Credential | DC
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Telephone | 716-799-4582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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