Provider Demographics
NPI:1790940765
Name:VAN ZEILEN FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:VAN ZEILEN FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:VAN ZEILEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-227-8290
Mailing Address - Street 1:550 LATONA ROAD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626
Mailing Address - Country:US
Mailing Address - Phone:585-227-8290
Mailing Address - Fax:585-227-5385
Practice Address - Street 1:550 LATONA ROAD
Practice Address - Street 2:SUITE 404
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2700
Practice Address - Country:US
Practice Address - Phone:585-227-8290
Practice Address - Fax:585-227-5385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011182-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0847Medicare UPIN