Provider Demographics
NPI:1225432958
Name:FARRELL, JESSICA (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:FARRELL
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 1:3868 E ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2001
Mailing Address - Country:US
Mailing Address - Phone:716-564-2225
Mailing Address - Fax:888-484-2163
Practice Address - Street 1:3868 E ROBINSON RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2001
Practice Address - Country:US
Practice Address - Phone:716-564-2225
Practice Address - Fax:888-484-2163
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012391-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor