Provider Demographics
NPI:1851790711
Name:MUSCULOSKELETAL HEALTH CENTERS LLC
Entity Type:Organization
Organization Name:MUSCULOSKELETAL HEALTH CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHIKEZIE
Authorized Official - Last Name:IJOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-413-2547
Mailing Address - Street 1:381 HOPMEADOW ST STE 303
Mailing Address - Street 2:
Mailing Address - City:WEATOGUE
Mailing Address - State:CT
Mailing Address - Zip Code:06089-9697
Mailing Address - Country:US
Mailing Address - Phone:860-413-2547
Mailing Address - Fax:
Practice Address - Street 1:381 HOPMEADOW ST STE 303
Practice Address - Street 2:
Practice Address - City:WEATOGUE
Practice Address - State:CT
Practice Address - Zip Code:06089-9697
Practice Address - Country:US
Practice Address - Phone:860-413-2547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-17
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty