Provider Demographics
NPI:1740232131
Name:VALLEY CHIROPRACTIC & REHABILITATION, LLC
Entity Type:Organization
Organization Name:VALLEY CHIROPRACTIC & REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:R
Authorized Official - Last Name:STOROZUK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:413-536-0142
Mailing Address - Street 1:850 HIGH ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3739
Mailing Address - Country:US
Mailing Address - Phone:413-536-0142
Mailing Address - Fax:413-536-0607
Practice Address - Street 1:850 HIGH ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3739
Practice Address - Country:US
Practice Address - Phone:413-536-0142
Practice Address - Fax:413-536-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPT0321Medicare PIN