National Provider Identifier
Jaelle Tamara Bacon, DC
Jaelle Tamara Bacon, DC is listed in the NPPES registry with a primary specialty of Chiropractor in Buffalo, NY and a listed phone number of (716) 335-9711.
Profile Overview
- NPI
- 1548740533
- Provider Type
- Individual
- Primary Specialty
- Chiropractor
- Enumeration Date
- August 19, 2018
- Last Updated
- August 19, 2018
Practice Location
- 2625 Delaware Ave Ste 102
- Buffalo, NY 14216-1705
Phone: (716) 335-9711
Specialties
- Chiropractor (111N00000X)
Full Record
- NPI
- 1548740533
- Entity Type
- Individual
- Last Name
- Bacon
- First Name
- Jaelle
- Middle Name
- Tamara
- Credential
- DC
- Mailing Street Address
- 2625 Delaware Ave Ste 102
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14216-1705
- Mailing Country
- US
- Mailing Phone
- (716) 335-9711
- Practice Street Address
- 2625 Delaware Ave Ste 102
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14216-1705
- Practice Country
- US
- Practice Phone
- (716) 335-9711
- Enumeration Date
- August 19, 2018
- Last Updated
- August 19, 2018
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Chiropractor (111N00000X)