Provider Demographics
NPI:1669944542
Name:KENT CHIROPRACTIC ASSOCIATES LLC
Entity type:Organization
Organization Name:KENT CHIROPRACTIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:CHIKEZIE
Authorized Official - Last Name:IJOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-502-5908
Mailing Address - Street 1:PO BOX 912
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:CT
Mailing Address - Zip Code:06757-0912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:860-773-0608
Practice Address - Street 1:64 MAPLE ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:CT
Practice Address - Zip Code:06757-1721
Practice Address - Country:US
Practice Address - Phone:860-502-5908
Practice Address - Fax:860-773-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty