Provider Demographics
NPI:1447433123
Name:CONNECTICUT CENTER FOR INTEGRATED HEALTHCARE LLC
Entity Type:Organization
Organization Name:CONNECTICUT CENTER FOR INTEGRATED HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:T
Authorized Official - Last Name:SOLLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-740-2739
Mailing Address - Street 1:246 FEDERAL RD STE C35
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2650
Mailing Address - Country:US
Mailing Address - Phone:203-740-2739
Mailing Address - Fax:203-740-0124
Practice Address - Street 1:246 FEDERAL RD STE C35
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2650
Practice Address - Country:US
Practice Address - Phone:203-740-2739
Practice Address - Fax:203-740-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1337111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty