Provider Demographics
NPI:1861840225
Name:STAMFORD CHIROPRACTIC & REHAB CENTER
Entity Type:Organization
Organization Name:STAMFORD CHIROPRACTIC & REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:HARRISON
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-276-1293
Mailing Address - Street 1:970 SUMMER ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5542
Mailing Address - Country:US
Mailing Address - Phone:203-276-1293
Mailing Address - Fax:203-595-5216
Practice Address - Street 1:970 SUMMER ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5542
Practice Address - Country:US
Practice Address - Phone:203-276-1293
Practice Address - Fax:203-595-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002022111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty