Provider Demographics
NPI:1447616941
Name:THIRD STONE INTEGRATIVE HEALTH CENTER
Entity Type:Organization
Organization Name:THIRD STONE INTEGRATIVE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:HALSALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-661-4662
Mailing Address - Street 1:3 WILDWOOD MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:CT
Mailing Address - Zip Code:06426-1155
Mailing Address - Country:US
Mailing Address - Phone:860-661-4662
Mailing Address - Fax:860-661-4654
Practice Address - Street 1:3 WILDWOOD MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1155
Practice Address - Country:US
Practice Address - Phone:860-661-4662
Practice Address - Fax:860-661-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000313175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1962561837OtherINDIVIDUAL NPI