Provider Demographics
NPI:1043225774
Name:MUNROE CHIROPRACTIC
Entity Type:Organization
Organization Name:MUNROE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNROE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-632-4476
Mailing Address - Street 1:6035 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6865
Mailing Address - Country:US
Mailing Address - Phone:716-632-4476
Mailing Address - Fax:716-632-4503
Practice Address - Street 1:6035 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6865
Practice Address - Country:US
Practice Address - Phone:716-632-4476
Practice Address - Fax:716-632-4503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA0973Medicare PIN