Provider Demographics
NPI:1972917102
Name:FAMILY FIRST CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:FAMILY FIRST CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBIECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:802-860-0382
Mailing Address - Street 1:525 HERCULES DR
Mailing Address - Street 2:STE 1B
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-5993
Mailing Address - Country:US
Mailing Address - Phone:802-860-0382
Mailing Address - Fax:802-655-0154
Practice Address - Street 1:525 HERCULES DR
Practice Address - Street 2:STE 1B
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5993
Practice Address - Country:US
Practice Address - Phone:802-860-0382
Practice Address - Fax:802-655-0154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT006-0001073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009535Medicaid
VTVN3110Medicare PIN