Provider Demographics
NPI:1073115226
Name:REDMOND, DANYELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANYELLE
Middle Name:
Last Name:REDMOND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-3208
Mailing Address - Country:US
Mailing Address - Phone:716-868-7794
Mailing Address - Fax:
Practice Address - Street 1:745 MILLERSPORT HWY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2409
Practice Address - Country:US
Practice Address - Phone:716-300-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor