Provider Demographics
NPI:1508131152
Name:CHIROPRACTIC CARE CENTER INC
Entity Type:Organization
Organization Name:CHIROPRACTIC CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-362-3040
Mailing Address - Street 1:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255-1228
Mailing Address - Country:US
Mailing Address - Phone:802-362-3040
Mailing Address - Fax:802-362-2811
Practice Address - Street 1:19 GREEN MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-1228
Practice Address - Country:US
Practice Address - Phone:802-362-3040
Practice Address - Fax:802-362-2811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-15
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty