Provider Demographics
NPI:1003238593
Name:DANBURY CHIROPRACTIC AND WELLNESS CORP
Entity Type:Organization
Organization Name:DANBURY CHIROPRACTIC AND WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:DILORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-792-9582
Mailing Address - Street 1:85 NORTH ST UNIT 7
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5635
Mailing Address - Country:US
Mailing Address - Phone:203-792-5982
Mailing Address - Fax:203-792-2091
Practice Address - Street 1:85 NORTH ST UNIT 7
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5635
Practice Address - Country:US
Practice Address - Phone:203-792-5982
Practice Address - Fax:203-792-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty