Provider Demographics
NPI:1457610065
Name:BECHARD, PHILIP JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JOHN
Last Name:BECHARD
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 1:1174 MOUNT HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2911
Mailing Address - Country:US
Mailing Address - Phone:585-445-8584
Mailing Address - Fax:585-445-8605
Practice Address - Street 1:1174 MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2911
Practice Address - Country:US
Practice Address - Phone:585-445-8584
Practice Address - Fax:585-445-8605
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70012218-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor