Provider Demographics
NPI:1851524987
Name:SYRACUSE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:SYRACUSE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SYRACUSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-542-3530
Mailing Address - Street 1:12364 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:NY
Mailing Address - Zip Code:14001-9307
Mailing Address - Country:US
Mailing Address - Phone:716-542-3530
Mailing Address - Fax:716-542-3619
Practice Address - Street 1:12364 MAIN RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001-9307
Practice Address - Country:US
Practice Address - Phone:716-542-3530
Practice Address - Fax:716-542-3619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty