Provider Demographics
NPI:1255477220
Name:CHIROPRACTIC FAMILY HEALTH CENTER OF MANCHESTER,LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC FAMILY HEALTH CENTER OF MANCHESTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:JANCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-649-2225
Mailing Address - Street 1:63 E CENTER ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-5221
Mailing Address - Country:US
Mailing Address - Phone:860-649-2225
Mailing Address - Fax:860-649-2220
Practice Address - Street 1:63 E CENTER ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-5221
Practice Address - Country:US
Practice Address - Phone:860-649-2225
Practice Address - Fax:860-649-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty