Provider Demographics
NPI:1689088395
Name:CENTER FOR NATURAL WELLNESS
Entity Type:Organization
Organization Name:CENTER FOR NATURAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR AND ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:KARPENKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, ACCP
Authorized Official - Phone:860-693-0255
Mailing Address - Street 1:166 ALBANY TPKE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-2546
Mailing Address - Country:US
Mailing Address - Phone:860-693-0255
Mailing Address - Fax:860-693-4250
Practice Address - Street 1:166 ALBANY TPKE
Practice Address - Street 2:SUITE 10
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-2546
Practice Address - Country:US
Practice Address - Phone:860-693-0255
Practice Address - Fax:860-693-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001489111N00000X
111NN1001X, 111NP0017X, 111NR0400X, 111NS0005X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689973059OtherINDIVIDUAL NPI