Provider Demographics
NPI:1407167851
Name:APPALACHIAN CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:APPALACHIAN CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-790-4600
Mailing Address - Street 1:103 MILL PLAIN RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811
Mailing Address - Country:US
Mailing Address - Phone:203-790-4600
Mailing Address - Fax:203-790-4601
Practice Address - Street 1:103 MILL PLAIN ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811
Practice Address - Country:US
Practice Address - Phone:203-790-4600
Practice Address - Fax:203-790-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty