Provider Demographics
NPI:1275851263
Name:KOSTEK CHIROPRACTIC OFFICES, PLLC
Entity type:Organization
Organization Name:KOSTEK CHIROPRACTIC OFFICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOSTEK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-634-4133
Mailing Address - Street 1:8643 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6315
Mailing Address - Country:US
Mailing Address - Phone:716-634-4133
Mailing Address - Fax:716-634-4140
Practice Address - Street 1:8643 SHERIDAN DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6315
Practice Address - Country:US
Practice Address - Phone:716-634-4133
Practice Address - Fax:716-634-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006972111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty