Provider Demographics
NPI:1972260453
Name:LUCAS JAMES HALLIWELL AND STEPHANIE HALLIWELL CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:LUCAS JAMES HALLIWELL AND STEPHANIE HALLIWELL CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLIWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-877-6582
Mailing Address - Street 1:61 MONTFORT DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1337
Mailing Address - Country:US
Mailing Address - Phone:315-877-6582
Mailing Address - Fax:
Practice Address - Street 1:6332 S TRANSIT RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-6336
Practice Address - Country:US
Practice Address - Phone:716-434-3889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty