Provider Demographics
NPI:1982143236
Name:SYNERGY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SYNERGY CHIROPRACTIC LLC
Other - Org Name:SYNERGY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TROKNYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-258-4004
Mailing Address - Street 1:2150 BLACK ROCK TPKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-3239
Mailing Address - Country:US
Mailing Address - Phone:203-259-3210
Mailing Address - Fax:
Practice Address - Street 1:2150 BLACK ROCK TPKE
Practice Address - Street 2:SUITE 2
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-3239
Practice Address - Country:US
Practice Address - Phone:203-259-3210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001265111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty