Provider Demographics
NPI:1588810915
Name:ALFRED ALMOND CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:ALFRED ALMOND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:607-247-4017
Mailing Address - Street 1:49 HILLCREST DR
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:ALFRED
Mailing Address - State:NY
Mailing Address - Zip Code:14802-1007
Mailing Address - Country:US
Mailing Address - Phone:607-247-4017
Mailing Address - Fax:607-247-4018
Practice Address - Street 1:49 HILLCREST DR
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:ALFRED
Practice Address - State:NY
Practice Address - Zip Code:14802-1007
Practice Address - Country:US
Practice Address - Phone:607-247-4017
Practice Address - Fax:607-247-4018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010766-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV11737Medicare UPIN