Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X003073 | NY |
NPI | 1255413555 |
---|---|
Provider Name | Dr. Edward Patrick Doyle III |
First Address | Rochester, NY 14625-2302 |
Second Address | Rochester, NY 14625-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |