Provider Demographics
NPI:1851471387
Name:EGAN, JONATHON TODD (DC, MPH)
Entity Type:Individual
Prefix:DR
First Name:JONATHON
Middle Name:TODD
Last Name:EGAN
Suffix:
Gender:M
Credentials:DC, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2954 E BAYARD STREET EXT
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-8744
Mailing Address - Country:US
Mailing Address - Phone:315-568-2531
Mailing Address - Fax:
Practice Address - Street 1:465 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4645
Practice Address - Country:US
Practice Address - Phone:585-463-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011225-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor