Provider Demographics
NPI:1407128333
Name:MENTA CHIROPRACTIC, LLC.
Entity Type:Organization
Organization Name:MENTA CHIROPRACTIC, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCO
Authorized Official - Middle Name:
Authorized Official - Last Name:MENTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-713-8833
Mailing Address - Street 1:9 RESEARCH DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-2863
Mailing Address - Country:US
Mailing Address - Phone:203-713-8833
Mailing Address - Fax:203-713-8844
Practice Address - Street 1:148 RESEARCH DR STE A
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-8537
Practice Address - Country:US
Practice Address - Phone:203-713-8833
Practice Address - Fax:203-713-8844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001281111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD100063750OtherMEDICARE PTAN