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General NPI Number Information
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NPI Number | 1437386323
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC & WELLNESS CENTER OF NEW HAVEN
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 59 ELM ST 100
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City | NEW HAVEN
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State | CT
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Zip | 06510-2047
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Country | US
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Telephone | 203-909-6173
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Fax |
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Provider Business Mailing Address
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Address Line | 59 ELM ST 100
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City | NEW HAVEN
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State | CT
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Zip | 06510-2047
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Country | US
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Telephone | 203-909-6173
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JONATHAN F HRYB
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Credential | DC
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Telephone | 203-605-9721
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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 | 001559
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License Number State | CT
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