Provider Demographics
NPI:1891829834
Name:KUMMER CHIROPRACTIC PC
Entity Type:Organization
Organization Name:KUMMER CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-731-2225
Mailing Address - Street 1:5215 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:SANBORN
Mailing Address - State:NY
Mailing Address - Zip Code:14132-9399
Mailing Address - Country:US
Mailing Address - Phone:716-731-2225
Mailing Address - Fax:
Practice Address - Street 1:5215 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:SANBORN
Practice Address - State:NY
Practice Address - Zip Code:14132-9399
Practice Address - Country:US
Practice Address - Phone:716-731-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0312Medicare ID - Type Unspecified