Provider Demographics
NPI:1083858161
Name:A&M CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:A&M CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLODZIEJCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-398-5420
Mailing Address - Street 1:160 WEST STREET
Mailing Address - Street 2:STE C
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-2441
Mailing Address - Country:US
Mailing Address - Phone:860-398-5420
Mailing Address - Fax:860-398-5424
Practice Address - Street 1:160 WEST STREET
Practice Address - Street 2:STE C
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-2441
Practice Address - Country:US
Practice Address - Phone:860-398-5420
Practice Address - Fax:860-398-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty