Provider Demographics
NPI:1073959581
Name:BACKMAN, DEBORAH K (DC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:K
Last Name:BACKMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:6513 CAMPBELL BLVD.
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094
Mailing Address - Country:US
Mailing Address - Phone:716-625-9066
Mailing Address - Fax:716-625-9022
Practice Address - Street 1:6513 CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-625-9066
Practice Address - Fax:716-625-9022
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-13
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012275-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor