Provider Demographics
NPI:1326369836
Name:KOCHERSBERGER, AMY ELIZABETH (DC, CACCP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:KOCHERSBERGER
Suffix:
Gender:F
Credentials:DC, CACCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1882 WINTON RD S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3950
Mailing Address - Country:US
Mailing Address - Phone:585-310-8900
Mailing Address - Fax:585-310-8901
Practice Address - Street 1:1882 WINTON RD S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3950
Practice Address - Country:US
Practice Address - Phone:585-310-8900
Practice Address - Fax:585-310-8901
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012013111N00000X
NYX012013-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor