Healthcare Provider Details

I. General information

NPI: 1134396799
Provider Name (Legal Business Name): KOCIS CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1196 NEW LITCHFIELD ST
TORRINGTON CT
06790-6016
US

IV. Provider business mailing address

1196 NEW LITCHFIELD ST
TORRINGTON CT
06790-6016
US

V. Phone/Fax

Practice location:
  • Phone: 860-626-9600
  • Fax: 860-626-9800
Mailing address:
  • Phone: 860-626-9600
  • Fax: 860-626-9800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number00883
License Number StateCT

VIII. Authorized Official

Name: DR. LEONARD FRANCIS KOCIS
Title or Position: PRESIDENT
Credential: DC
Phone: 860-626-9600