Provider Demographics
NPI:1265680425
Name:NATURAL BODY ALIGNMENT, LLC
Entity Type:Organization
Organization Name:NATURAL BODY ALIGNMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:T
Authorized Official - Last Name:CORMIER
Authorized Official - Suffix:
Authorized Official - Credentials:MS ATC CSCS
Authorized Official - Phone:203-248-5146
Mailing Address - Street 1:1 EVERGREEN AVE STE 32
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-2717
Mailing Address - Country:US
Mailing Address - Phone:203-248-5146
Mailing Address - Fax:
Practice Address - Street 1:1 EVERGREEN AVE STE 32
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-2717
Practice Address - Country:US
Practice Address - Phone:203-248-5146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000327261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy