Provider Demographics
NPI:1629371075
Name:ACUPUNCTURE AND MASSAGE OF WESTERN NEW YORK PC
Entity type:Organization
Organization Name:ACUPUNCTURE AND MASSAGE OF WESTERN NEW YORK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:585-346-4510
Mailing Address - Street 1:6003 BIG TREE RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14480-9753
Mailing Address - Country:US
Mailing Address - Phone:585-346-4510
Mailing Address - Fax:585-346-4510
Practice Address - Street 1:6003 BIG TREE RD
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:NY
Practice Address - Zip Code:14480-9753
Practice Address - Country:US
Practice Address - Phone:585-346-4510
Practice Address - Fax:585-346-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty