Provider Demographics
NPI:1114165487
Name:DAMATO CHIROPRACTIC CENTER, L L C
Entity Type:Organization
Organization Name:DAMATO CHIROPRACTIC CENTER, L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-436-2065
Mailing Address - Street 1:123 LOWREY PL
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-3003
Mailing Address - Country:US
Mailing Address - Phone:860-436-2065
Mailing Address - Fax:860-436-2066
Practice Address - Street 1:123 LOWREY PL
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3003
Practice Address - Country:US
Practice Address - Phone:860-436-2065
Practice Address - Fax:860-436-2066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001424111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty