Healthcare Provider Details

I. General information

NPI: 1306262753
Provider Name (Legal Business Name): SYKES FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 03/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 MAIN ST 302
DURHAM CT
06422-2116
US

IV. Provider business mailing address

16 MAIN ST 302
DURHAM CT
06422-2116
US

V. Phone/Fax

Practice location:
  • Phone: 860-349-0639
  • Fax:
Mailing address:
  • Phone: 860-349-0639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1969
License Number StateCT

VIII. Authorized Official

Name: DR. TREVOR NQ SYKES
Title or Position: CHIROPRACTOR
Credential: D.C
Phone: 770-313-5050