Provider Demographics
NPI:1316183387
Name:LANDERS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:LANDERS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-209-7219
Mailing Address - Street 1:72 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3965
Mailing Address - Country:US
Mailing Address - Phone:315-370-7988
Mailing Address - Fax:888-345-8190
Practice Address - Street 1:72 SOUTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3965
Practice Address - Country:US
Practice Address - Phone:315-370-7988
Practice Address - Fax:888-345-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty