Provider Demographics
NPI:1619704855
Name:GAWLAK, KAYLA MARIE (DC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:GAWLAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3648 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3400
Mailing Address - Country:US
Mailing Address - Phone:716-771-1354
Mailing Address - Fax:
Practice Address - Street 1:3648 SENECA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14224-3400
Practice Address - Country:US
Practice Address - Phone:716-628-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013878111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor