Provider Demographics
NPI:1568509479
Name:WESTSIDE CHIROPRACTIC AND WELLNESS, PLLC
Entity Type:Organization
Organization Name:WESTSIDE CHIROPRACTIC AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRONGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-247-1080
Mailing Address - Street 1:835 SPENCERPORT RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4821
Mailing Address - Country:US
Mailing Address - Phone:585-247-1080
Mailing Address - Fax:585-429-5220
Practice Address - Street 1:835 SPENCERPORT RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-4821
Practice Address - Country:US
Practice Address - Phone:585-247-1080
Practice Address - Fax:585-429-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0082501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty