Provider Demographics
NPI:1902271414
Name:CHIRO FIRST WELLNESS CENTER
Entity Type:Organization
Organization Name:CHIRO FIRST WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:716-675-2225
Mailing Address - Street 1:4214 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1606
Mailing Address - Country:US
Mailing Address - Phone:716-675-2225
Mailing Address - Fax:716-675-2222
Practice Address - Street 1:4214 CLINTON ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1606
Practice Address - Country:US
Practice Address - Phone:716-675-2225
Practice Address - Fax:716-675-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY70012570302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization