Provider Demographics
NPI:1003883935
Name:MCGRIMLEY, WILLIAM A (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:A
Last Name:MCGRIMLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148
Mailing Address - Country:US
Mailing Address - Phone:315-568-6767
Mailing Address - Fax:315-368-0070
Practice Address - Street 1:27 STATE STREET
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148
Practice Address - Country:US
Practice Address - Phone:315-568-6767
Practice Address - Fax:315-368-0070
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010441111N00000X
NH6510202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD2092Medicare ID - Type Unspecified
U91503Medicare UPIN