Provider Demographics
NPI:1558607895
Name:SAWYER, JEFFREY BURTON LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BURTON LEE
Last Name:SAWYER
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 1:123 QUAKER RD STE 103
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-1714
Mailing Address - Country:US
Mailing Address - Phone:518-223-0118
Mailing Address - Fax:
Practice Address - Street 1:123 QUAKER RD STE 103
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1714
Practice Address - Country:US
Practice Address - Phone:518-223-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012262-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor