Provider Demographics
NPI:1114356946
Name:SOUTHTOWNS CHIROPRACTIC ASSOCIATES P.C.
Entity Type:Organization
Organization Name:SOUTHTOWNS CHIROPRACTIC ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:DOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-674-0821
Mailing Address - Street 1:3445 ORCHARD PARK RD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127
Mailing Address - Country:US
Mailing Address - Phone:716-674-0821
Mailing Address - Fax:716-674-0293
Practice Address - Street 1:3445 ORCHARD PARK RD.
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127
Practice Address - Country:US
Practice Address - Phone:716-674-0821
Practice Address - Fax:716-674-0293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011978-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty