Provider Demographics
NPI:1851941447
Name:INTEGRATIVE MUSCLE & JOINT CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE MUSCLE & JOINT CHIROPRACTIC, PLLC
Other - Org Name:PRIME SPINE ASSOCIATES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-674-0455
Mailing Address - Street 1:2701 TRANSIT RD STE 135
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-9032
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 TRANSIT RD STE 135
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:NY
Practice Address - Zip Code:14059-9032
Practice Address - Country:US
Practice Address - Phone:716-674-0455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty