Provider Demographics
NPI:1073646238
Name:BLANKENSHIP, CHERYL CHAO (DC LAC)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:CHAO
Last Name:BLANKENSHIP
Suffix:
Gender:F
Credentials:DC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4131
Mailing Address - Country:US
Mailing Address - Phone:860-886-2882
Mailing Address - Fax:860-886-6886
Practice Address - Street 1:148 SACHEM ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-4131
Practice Address - Country:US
Practice Address - Phone:860-886-2882
Practice Address - Fax:860-886-6886
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001644111N00000X
CT000494171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist