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General NPI Number Information
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NPI Number | 1154861094
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Entity Type | Organization
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Legal Business Name | A TEAM PERFORMANCE AND CHIROPRACTIC
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Dates
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Enumeration Date | 02/26/2017
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Last Update Date | 02/26/2017
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Provider Practice Location Address
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Address Line | 1 N WATER ST
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City | NORWALK
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State | CT
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Zip | 06854-2260
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Country | US
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Telephone | 203-939-1465
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Fax |
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Provider Business Mailing Address
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Address Line | 1 N WATER ST
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City | NORWALK
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State | CT
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Zip | 06854-2260
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Country | US
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Telephone | 203-939-1465
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. DREW ACCOMANDO
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Credential |
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Telephone | 203-581-1927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2066
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License Number State | CT
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