Healthcare Provider Details

I. General information

NPI: 1871224196
Provider Name (Legal Business Name): AMENDOLA FAMILY CHIROPRACTIC & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CORPORATE DR UNIT B104
TRUMBULL CT
06611-6346
US

IV. Provider business mailing address

6131 MAIN ST
TRUMBULL CT
06611-2435
US

V. Phone/Fax

Practice location:
  • Phone: 203-590-3407
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ALAN JOSEPH AMENDOLA
Title or Position: OWNER
Credential: DC
Phone: 203-543-1250