Provider Demographics
NPI:1992070445
Name:SCHAFFSTALL CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:SCHAFFSTALL CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHAFFSTALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-580-3246
Mailing Address - Street 1:777 MAPLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3275
Mailing Address - Country:US
Mailing Address - Phone:716-580-3246
Mailing Address - Fax:
Practice Address - Street 1:777 MAPLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3275
Practice Address - Country:US
Practice Address - Phone:716-580-3246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011504-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty