Provider Demographics
NPI:1508997172
Name:BARTZ, JAMES THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:BARTZ
Suffix:
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 1:26 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-2309
Mailing Address - Country:US
Mailing Address - Phone:716-685-3823
Mailing Address - Fax:716-685-3823
Practice Address - Street 1:26 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-2309
Practice Address - Country:US
Practice Address - Phone:716-685-3823
Practice Address - Fax:716-685-3823
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20406OtherWORKERS COMPENSATION
NY076931Medicare ID - Type Unspecified