Provider Demographics
NPI:1780780601
Name:DENECKE, THOMAS D (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:D
Last Name:DENECKE
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 1:767 MINERAL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1053
Mailing Address - Country:US
Mailing Address - Phone:716-823-1343
Mailing Address - Fax:716-823-2113
Practice Address - Street 1:767 MINERAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1053
Practice Address - Country:US
Practice Address - Phone:716-823-1343
Practice Address - Fax:716-823-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002719-5B111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor