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General NPI Number Information
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NPI Number | 1578872024
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Entity Type | Organization
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Legal Business Name | PAPE CHIROPRACTIC & WELLNESS CENTER LLC
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 11 FREEDOM WAY UNIT B-01
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City | NIANTIC
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State | CT
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Zip | 06357-1041
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Country | US
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Telephone | 860-739-3600
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Fax | 860-739-3400
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Provider Business Mailing Address
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Address Line | PO BOX 944
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City | EAST LYME
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State | CT
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Zip | 06333-0944
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Country | US
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Telephone | 860-739-3600
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Fax | 860-739-3400
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIANNE A PAPE
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Credential | D.C.
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Telephone | 860-739-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 001857
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License Number State | CT
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