Provider Demographics
NPI:1225163553
Name:RUPLEY, DOROTHY S (DC)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:S
Last Name:RUPLEY
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 1:8054 NEWCO DR
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:NY
Mailing Address - Zip Code:14464-9727
Mailing Address - Country:US
Mailing Address - Phone:585-704-4419
Mailing Address - Fax:
Practice Address - Street 1:1722 LAKE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:HAMLIN
Practice Address - State:NY
Practice Address - Zip Code:14464-9590
Practice Address - Country:US
Practice Address - Phone:585-964-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC03861-4B111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035101Medicare ID - Type Unspecified
NY106037ANMedicare UPIN