Provider Demographics
NPI:1205343456
Name:ADVANCED CHIROPRACTIC WELLNESS CARE-DANBURY P.L.L.C
Entity type:Organization
Organization Name:ADVANCED CHIROPRACTIC WELLNESS CARE-DANBURY P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALGERIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-743-8093
Mailing Address - Street 1:41 KENOSIA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7360
Mailing Address - Country:US
Mailing Address - Phone:203-748-8093
Mailing Address - Fax:203-743-2142
Practice Address - Street 1:41 KENOSIA AVE STE 101
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7360
Practice Address - Country:US
Practice Address - Phone:203-748-8093
Practice Address - Fax:203-743-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty