Healthcare Provider Details

I. General information

NPI: 1750392650
Provider Name (Legal Business Name): FAMILY CHIROPRACTIC AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2337 WHITNEY AVE
HAMDEN CT
06518-3504
US

IV. Provider business mailing address

2337 WHITNEY AVE
HAMDEN CT
06518-3504
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-0607
  • Fax: 203-288-2650
Mailing address:
  • Phone: 203-288-0607
  • Fax: 203-288-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1399
License Number StateCT

VIII. Authorized Official

Name: DR. KARYN BRENTS
Title or Position: OWNER
Credential: DC
Phone: 203-288-0607