Provider Demographics
NPI:1386027878
Name:TROMBITAS, MICHAEL T (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:T
Last Name:TROMBITAS
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 1:244 BEWLEY BUILDING
Mailing Address - Street 2:MARKET STREET
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094
Mailing Address - Country:US
Mailing Address - Phone:716-201-1817
Mailing Address - Fax:716-201-1829
Practice Address - Street 1:244 BEWLEY BUILDING
Practice Address - Street 2:MARKET STREET
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-201-1817
Practice Address - Fax:716-201-1829
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor