Provider Demographics
NPI:1407188337
Name:PHIPPS, JAMES LEE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:PHIPPS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 S YOUNGS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7030
Mailing Address - Country:US
Mailing Address - Phone:716-629-3100
Mailing Address - Fax:
Practice Address - Street 1:390 S YOUNGS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7030
Practice Address - Country:US
Practice Address - Phone:716-629-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011953-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor