Provider Demographics
NPI:1083807028
Name:BLANCHARD, WILLIAM A (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:BLANCHARD
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 1:2541 MONROE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3123
Mailing Address - Country:US
Mailing Address - Phone:585-271-4270
Mailing Address - Fax:585-271-4279
Practice Address - Street 1:2541 MONROE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3123
Practice Address - Country:US
Practice Address - Phone:585-271-4270
Practice Address - Fax:585-271-4279
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor