Provider Demographics
NPI:1528592565
Name:MICHAEL MUTO DC, P.C.
Entity Type:Organization
Organization Name:MICHAEL MUTO DC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-837-6000
Mailing Address - Street 1:600 GROVER CLEVELAND HWY
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-2900
Mailing Address - Country:US
Mailing Address - Phone:716-837-6000
Mailing Address - Fax:716-837-6002
Practice Address - Street 1:600 GROVER CLEVELAND HWY
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2900
Practice Address - Country:US
Practice Address - Phone:716-837-6000
Practice Address - Fax:716-837-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008019-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty