Provider Demographics
NPI:1427386382
Name:WALTON CHIROPRACTIC
Entity Type:Organization
Organization Name:WALTON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:607-865-5500
Mailing Address - Street 1:15 TOWNSEND ST
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-1309
Mailing Address - Country:US
Mailing Address - Phone:607-865-5500
Mailing Address - Fax:607-865-5376
Practice Address - Street 1:15 TOWNSEND ST
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1309
Practice Address - Country:US
Practice Address - Phone:607-865-5500
Practice Address - Fax:607-865-5376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009739111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU81389Medicare UPIN