Provider Demographics
NPI:1427207182
Name:CHIROPRACTIC HEALTH & WELLNESS PC
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALTH & WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THAYER
Authorized Official - Middle Name:R
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-453-5588
Mailing Address - Street 1:14 SCHOOL ST.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BRISTOL
Mailing Address - State:VT
Mailing Address - Zip Code:05443
Mailing Address - Country:US
Mailing Address - Phone:802-453-5588
Mailing Address - Fax:802-453-7878
Practice Address - Street 1:14 SCHOOL ST.
Practice Address - Street 2:SUITE 105
Practice Address - City:BRISTOL
Practice Address - State:VT
Practice Address - Zip Code:05443
Practice Address - Country:US
Practice Address - Phone:802-453-5588
Practice Address - Fax:802-453-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0060001148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty