Organization
D.JORDAN CONRAD DC PC
Active
Other names
Genesis Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
D. JORDAN CONRAD DC (OWNER)
(716) 882-8800
Entity
Organization
Contact information
Practice address
313 ELMWOOD AVE, BUFFALO, NY 14222-2203
(716) 882-8800
(716) 881-1382
Mailing address
313 ELMWOOD AVE, BUFFALO, NY 14222-2203
(716) 882-8800
(716) 881-1382
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X0114531
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05084895
—
NY
Enumeration date
03/12/2010
Last updated
12/04/2019
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