Provider Demographics
NPI:1477205367
Name:MCNAMARA, ATTIE GIBSON (DC)
Entity Type:Individual
Prefix:
First Name:ATTIE
Middle Name:GIBSON
Last Name:MCNAMARA
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 1:1841 BILLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-1015
Mailing Address - Country:US
Mailing Address - Phone:716-949-9563
Mailing Address - Fax:
Practice Address - Street 1:15 LASALLE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2641
Practice Address - Country:US
Practice Address - Phone:716-949-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013533111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty