Provider Demographics
NPI:1891964862
Name:HARTSBURG CHIROPRACTIC HEALTH CENTER, LLC.
Entity Type:Organization
Organization Name:HARTSBURG CHIROPRACTIC HEALTH CENTER, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HARTSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-792-4476
Mailing Address - Street 1:40 LAKE AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-5283
Mailing Address - Country:US
Mailing Address - Phone:203-792-4476
Mailing Address - Fax:203-798-2168
Practice Address - Street 1:40 LAKE AVENUE EXT
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5283
Practice Address - Country:US
Practice Address - Phone:203-792-4476
Practice Address - Fax:203-798-2168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1564111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03497Medicare PIN