Provider Demographics
NPI:1831966464
Name:CLOTHIER CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:CLOTHIER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-912-9666
Mailing Address - Street 1:31 RANCH VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-2856
Mailing Address - Country:US
Mailing Address - Phone:716-912-9666
Mailing Address - Fax:585-319-4376
Practice Address - Street 1:3173 CHILI AVE STE 100
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5400
Practice Address - Country:US
Practice Address - Phone:716-912-9666
Practice Address - Fax:585-319-4376
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLOTHIER CHIROPRACTIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty