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SOUTH WINDSOR NECK AND BACK LLC NPI 1306065248


NPI Information

NPI: 1306065248
Provider Name: SOUTH WINDSOR NECK AND BACK, LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
1330 SULLIVAN AVE
SOUTH WINDSOR, CT
ZIP 06074
Phone: (860) 644-2437
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SOUTH WINDSOR NECK AND BACK, LLC is a chiropractor in South Windsor, CT. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. SOUTH WINDSOR NECK AND BACK, LLC NPI is 1306065248. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1330 SULLIVAN AVE
SOUTH WINDSOR, CT
ZIP 06074-713
Phone: (860) 644-2437
Fax: (860) 644-8590

The provider's authorized official is Andrew P Gregory .
The authorized official title is Owner Manager and has the following contact phone number (860) 644-2437.

The enumeration date for this NPI number is 4/25/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractor011490CONNECTICUTYes
2111NN0400XChiropractorNeurology001133CONNECTICUTX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11922042563OTHERCONNECTICUTROSANNE GREGORY NPI SOLO
2C03101OTHERCONNECTICUTMEDICARE GROUP NUMBER
31114961703OTHERCONNECTICUTANDREW GREGORY NPI SOLO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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