Provider Demographics
NPI:1184005704
Name:FINGER LAKES FAMILY CHIROPRACTIC WELLNESS P.C.
Entity Type:Organization
Organization Name:FINGER LAKES FAMILY CHIROPRACTIC WELLNESS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:VOROZILCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-789-9355
Mailing Address - Street 1:324 W. NORTH STREET,
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456
Mailing Address - Country:US
Mailing Address - Phone:315-789-9355
Mailing Address - Fax:
Practice Address - Street 1:324 W. NORTH STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456
Practice Address - Country:US
Practice Address - Phone:315-789-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70-011232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty