Provider Demographics
NPI:1518114628
Name:ACHIEVE WELLNESS CHIROPRACTIC
Entity Type:Organization
Organization Name:ACHIEVE WELLNESS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:COATES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-388-9390
Mailing Address - Street 1:210 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-2333
Mailing Address - Country:US
Mailing Address - Phone:860-388-9390
Mailing Address - Fax:860-388-9391
Practice Address - Street 1:210 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2333
Practice Address - Country:US
Practice Address - Phone:860-388-9390
Practice Address - Fax:860-388-9391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty