Provider Demographics
NPI:1457439887
Name:COFF, JOAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:
Last Name:COFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-2650
Mailing Address - Country:US
Mailing Address - Phone:315-635-2739
Mailing Address - Fax:
Practice Address - Street 1:92 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:BALDWINSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13027-2650
Practice Address - Country:US
Practice Address - Phone:315-635-2739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006638111N00000X
NM1187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor