Provider Demographics
NPI:1851449284
Name:GUFFEY, JAN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:MARIE
Last Name:GUFFEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 DUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:NY
Mailing Address - Zip Code:12993-1702
Mailing Address - Country:US
Mailing Address - Phone:518-962-4044
Mailing Address - Fax:
Practice Address - Street 1:3266 BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:PORT HENRY
Practice Address - State:NY
Practice Address - Zip Code:12974-1176
Practice Address - Country:US
Practice Address - Phone:518-546-3100
Practice Address - Fax:518-546-3101
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor