Provider Demographics
NPI:1457889784
Name:WARCHAL CHIROPRACTIC & SPORTS REHAB PLLC
Entity Type:Organization
Organization Name:WARCHAL CHIROPRACTIC & SPORTS REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:WARCHAL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:315-725-6698
Mailing Address - Street 1:6221 STATE ROUTE 31 STE 110B
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-8724
Mailing Address - Country:US
Mailing Address - Phone:315-288-4483
Mailing Address - Fax:315-288-4492
Practice Address - Street 1:6221 STATE ROUTE 31 STE 110B
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-8724
Practice Address - Country:US
Practice Address - Phone:315-288-4483
Practice Address - Fax:315-288-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011987-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty