Provider Demographics
NPI:1548281181
Name:VANCE, NEIL (DC)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:VANCE
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 1:1398 COACH RD
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-8871
Mailing Address - Country:US
Mailing Address - Phone:315-685-2070
Mailing Address - Fax:
Practice Address - Street 1:1398 COACH RD
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-8871
Practice Address - Country:US
Practice Address - Phone:315-685-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085TMOtherBCBS PROV NUMBER
NC085TMOtherBCBS PROV NUMBER
NC2457390Medicare ID - Type Unspecified