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General NPI Number Information
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NPI Number | 1689028292
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Entity Type | Organization
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Legal Business Name | SAUGATUCK CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 1045 POST RD E
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City | WESTPORT
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State | CT
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Zip | 06880-5370
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Country | US
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Telephone | 203-259-2124
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Fax | 203-259-2004
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Provider Business Mailing Address
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Address Line | 1045 POST RD E
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City | WESTPORT
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State | CT
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Zip | 06880-5370
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Country | US
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Telephone | 203-259-2124
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Fax | 203-259-2004
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. NATHAN D. KING
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Credential | D.C.
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Telephone | 203-259-2124
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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 | 001914
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License Number State | CT
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