Provider Demographics
NPI:1467710368
Name:COLBY FAMILY CHIROPRACTIC,LLC
Entity Type:Organization
Organization Name:COLBY FAMILY CHIROPRACTIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-871-0616
Mailing Address - Street 1:220 HARTFORD TPKE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4700
Mailing Address - Country:US
Mailing Address - Phone:860-871-0616
Mailing Address - Fax:860-872-1319
Practice Address - Street 1:220 HARTFORD TPKE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4700
Practice Address - Country:US
Practice Address - Phone:860-871-0616
Practice Address - Fax:860-872-1319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty