Healthcare Provider Details

I. General information

NPI: 1518196583
Provider Name (Legal Business Name): MARC W PLATT DC DBA/ COMMUNITY CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2009
Last Update Date: 07/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

336 WASHINGTON AVE
NORTH HAVEN CT
06473-1306
US

IV. Provider business mailing address

336 WASHINGTON AVE
NORTH HAVEN CT
06473-1306
US

V. Phone/Fax

Practice location:
  • Phone: 203-239-2323
  • Fax: 203-239-3325
Mailing address:
  • Phone: 203-239-2323
  • Fax: 203-239-3325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number000411
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number003156
License Number StateCT

VIII. Authorized Official

Name: DR. MARC W PLATT
Title or Position: OWNER
Credential: DC
Phone: 203-239-2323