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General NPI Number Information
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NPI Number | 1194009860
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Entity Type | Organization
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Legal Business Name | QI ACUPUNCTURE & CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 840 MONROE TPKE
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City | MONROE
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State | CT
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Zip | 06468-1962
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Country | US
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Telephone | 203-220-8879
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Fax |
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Provider Business Mailing Address
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Address Line | 840 MONROE TPKE
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City | MONROE
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State | CT
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Zip | 06468-1962
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Country | US
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Telephone | 203-220-8879
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. WAYNE SCOTT HARRISON JR.
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Credential | D.C.
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Telephone | 203-261-2348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 001199
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License Number State | CT
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