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General NPI Number Information
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NPI Number | 1982967063
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Entity Type | Organization
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Legal Business Name | D'YOUVILLE COLLEGE
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 320 PORTER AVE
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City | BUFFALO
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State | NY
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Zip | 14201-1032
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Country | US
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Telephone | 716-829-7583
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Fax | 716-829-7583
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Provider Business Mailing Address
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Address Line | 320 PORTER AVE
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City | BUFFALO
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State | NY
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Zip | 14201-1032
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Country | US
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Telephone | 716-829-7583
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Fax | 716-829-7583
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | NATHAN R MARTON
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Credential |
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Telephone | 716-829-7583
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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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