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General NPI Number Information
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NPI Number | 1255635520
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Entity Type | Organization
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Legal Business Name | ROBERTS CHIROPRACTIC & WELLNESS CENTER OF GREENWICH LLC
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Dates
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Enumeration Date | 12/30/2010
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Last Update Date | 12/30/2010
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Provider Practice Location Address
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Address Line | 2 1/2 DEARFIELD DR SUITE 101
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City | GREENWICH
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State | CT
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Zip | 06831-5335
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Country | US
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Telephone | 203-769-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 2 1/2 DEARFIELD DR SUITE 101
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City | GREENWICH
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State | CT
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Zip | 06831-5335
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Country | US
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Telephone | 203-769-1555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARL MICHAEL ROBERTS
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Credential | D.C.
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Telephone | 203-769-1555
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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 | 001836
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License Number State | CT
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