Provider Demographics
NPI:1801344304
Name:VALLEY CHIROPRACTIC AND SPORTS MEDICINE LLC
Entity type:Organization
Organization Name:VALLEY CHIROPRACTIC AND SPORTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:INLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-413-2727
Mailing Address - Street 1:244 FARMS VILLAGE RD UNIT L
Mailing Address - Street 2:PO BOX 485
Mailing Address - City:WEST SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06092-0485
Mailing Address - Country:US
Mailing Address - Phone:860-413-2727
Mailing Address - Fax:860-413-2730
Practice Address - Street 1:244 FARMS VILLAGE RD UNIT L
Practice Address - Street 2:
Practice Address - City:WEST SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06092-2407
Practice Address - Country:US
Practice Address - Phone:860-413-2727
Practice Address - Fax:860-413-2730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1174974976Medicaid
MA1659469823Medicaid