Provider Demographics
NPI:1851758809
Name:DRITSCHEL, JUSTIN ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ALAN
Last Name:DRITSCHEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6951 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-3022
Mailing Address - Country:US
Mailing Address - Phone:716-287-5048
Mailing Address - Fax:
Practice Address - Street 1:6951 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-3022
Practice Address - Country:US
Practice Address - Phone:716-287-5048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012979111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor