Provider Demographics
NPI:1811616725
Name:AVALLON CHIROPRACTIC & WELLNESS, LLC
Entity type:Organization
Organization Name:AVALLON CHIROPRACTIC & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:AVALLON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-955-1147
Mailing Address - Street 1:1220 POST RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6036
Mailing Address - Country:US
Mailing Address - Phone:203-955-1147
Mailing Address - Fax:
Practice Address - Street 1:1220 POST RD STE 1
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6036
Practice Address - Country:US
Practice Address - Phone:203-955-1147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty