Provider Demographics
NPI:1497025746
Name:CALATAYUD CHIROPRACTIC CENTER, PC
Entity type:Organization
Organization Name:CALATAYUD CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CALATAYUD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-294-1700
Mailing Address - Street 1:85 BARNES RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1832
Mailing Address - Country:US
Mailing Address - Phone:203-294-1700
Mailing Address - Fax:
Practice Address - Street 1:85 BARNES RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1832
Practice Address - Country:US
Practice Address - Phone:203-294-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000704111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty