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General NPI Number Information
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NPI Number | 1285184655
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Entity Type | Organization
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Legal Business Name | GREENWICH SPORTS MEDICINE AT TWIN RINKS LLC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 04/14/2017
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Provider Practice Location Address
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Address Line | 1063 HOPE ST SECOND FLOOR
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City | STAMFORD
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State | CT
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Zip | 06907-2109
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Country | US
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Telephone | 203-540-5155
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Fax | 203-540-5111
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Provider Business Mailing Address
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Address Line | 1063 HOPE ST SECOND FLOOR
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City | STAMFORD
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State | CT
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Zip | 06907-2109
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Country | US
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Telephone | 203-540-5155
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Fax | 203-540-5111
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Authorized Official
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Title or Position | PARTNER
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Name | DR. GIL CHIMES
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Credential | DC.
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Telephone | 203-531-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1957
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1883
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1685
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1228
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License Number State | CT
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