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General NPI Number Information
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NPI Number | 1669674412
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Entity Type | Organization
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Legal Business Name | ANSONIA CHIROPRACTIC AND REHABILITATION, LLC
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 44 BRIDGE ST
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City | ANSONIA
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State | CT
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Zip | 06401-1818
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Country | US
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Telephone | 203-736-6356
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Fax | 203-734-6781
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Provider Business Mailing Address
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Address Line | 44 BRIDGE ST
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City | ANSONIA
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State | CT
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Zip | 06401-1818
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Country | US
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Telephone | 203-736-6356
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Fax | 203-734-6781
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JENNIFER M SWIATOWICZ
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Credential | DC
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Telephone | 203-736-6356
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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 | 001715
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License Number State | CT
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