Provider Demographics
NPI:1649784372
Name:FAMILY HEALTH CHIROPRACTIC CARE, LLC
Entity type:Organization
Organization Name:FAMILY HEALTH CHIROPRACTIC CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:STAMANT
Authorized Official - Last Name:CHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DABCI
Authorized Official - Phone:860-651-7387
Mailing Address - Street 1:22 HORSESHOE CIR
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-1742
Mailing Address - Country:US
Mailing Address - Phone:860-651-7387
Mailing Address - Fax:
Practice Address - Street 1:540 HOPMEADOW ST APT 1
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-3194
Practice Address - Country:US
Practice Address - Phone:860-651-3355
Practice Address - Fax:860-408-9648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty