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General NPI Number Information
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NPI Number | 1598055683
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Entity Type | Organization
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Legal Business Name | MICHAEL VAJDA, D.C., L.L.C.
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 761 WASHINGTON ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2903
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Country | US
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Telephone | 860-343-0222
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Fax | 860-343-1544
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Provider Business Mailing Address
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Address Line | 761 WASHINGTON ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2903
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Country | US
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Telephone | 860-343-0222
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Fax | 860-343-1544
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. MICHAEL VAJDA
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Credential | D.C.
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Telephone | 860-343-0222
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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 | 649
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License Number State | CT
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