Provider Demographics
NPI:1306663778
Name:MEACHAM CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:MEACHAM CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEACHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-262-5545
Mailing Address - Street 1:66 COUNTY ROUTE 52 POBOX 188
Mailing Address - Street 2:
Mailing Address - City:NORTH LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:12967
Mailing Address - Country:US
Mailing Address - Phone:315-262-5455
Mailing Address - Fax:
Practice Address - Street 1:6604 NY-56
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676
Practice Address - Country:US
Practice Address - Phone:315-261-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty