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General NPI Number Information
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NPI Number | 1649569641
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Entity Type | Organization
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Legal Business Name | LITCHFIELD COUNTY ORTHOPEDIC & SPINE PC
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 538 LITCHFIELD ST STE 202
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City | TORRINGTON
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State | CT
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Zip | 06790-6669
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Country | US
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Telephone | 860-361-6650
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Fax | 860-361-6654
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Provider Business Mailing Address
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Address Line | 538 LITCHFIELD ST STE 202
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City | TORRINGTON
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State | CT
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Zip | 06790-6669
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Country | US
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Telephone | 860-361-6650
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Fax | 860-361-6654
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MITCHELL S GARDEN
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Credential | MD
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Telephone | 860-361-6650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 044118
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License Number State | CT
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