Provider Demographics
NPI:1376818682
Name:FAILING CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:FAILING CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAILING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-544-3759
Mailing Address - Street 1:1880 EAST RIDGE ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622
Mailing Address - Country:US
Mailing Address - Phone:585-544-3759
Mailing Address - Fax:585-544-3884
Practice Address - Street 1:1880 EAST RIDGE ROAD
Practice Address - Street 2:SUITE 2
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14622
Practice Address - Country:US
Practice Address - Phone:585-544-3759
Practice Address - Fax:585-544-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB0373Medicare PIN