Provider Demographics
NPI:1245479237
Name:LITCHFIELD COUNTY CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:LITCHFIELD COUNTY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:L
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-350-8505
Mailing Address - Street 1:37 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3507
Mailing Address - Country:US
Mailing Address - Phone:860-350-8505
Mailing Address - Fax:860-350-9112
Practice Address - Street 1:37 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-3507
Practice Address - Country:US
Practice Address - Phone:860-350-8505
Practice Address - Fax:860-350-9112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000230CTMedicare UPIN