MEDICARE: DR. WILLIAM A BLANCHARD DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	008427	NY

General Provider Information

NPI Number	:	1083807028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM A BLANCHARD DC

Provider Business Mailing Address
First Line	:	2541 MONROE AVE
Second Line	:	SUITE 103
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3123
Country	:	US
Telephone Number	:	585-271-4270
Fax Number	:	585-271-4279

Provider Business Practice Location Address
First Line	:	2541 MONROE AVE
Second Line	:	SUITE 103
City	:	ROCHESTER
State	:	NY
Zip	:	14618-3123
Country	:	US
Telephone Number	:	585-271-4270
Fax Number	:	585-271-4279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	08/23/2007

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