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General NPI Number Information
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NPI Number | 1144475245
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Entity Type | Organization
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Legal Business Name | CAPITOL CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 24 LEWIS ST
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City | HARTFORD
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State | CT
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Zip | 06103-2501
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Country | US
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Telephone | 860-278-9141
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Fax | 860-525-4013
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Provider Business Mailing Address
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Address Line | 24 LEWIS ST
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City | HARTFORD
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State | CT
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Zip | 06103-2501
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Country | US
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Telephone | 860-278-9141
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Fax | 860-525-4013
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. KARLOS BOGHOSIAN
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Credential | D.C
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Telephone | 860-278-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 001652
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 001779
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 001584
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License Number State | CT
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