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General NPI Number Information
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NPI Number | 1720481542
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Entity Type | Organization
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Legal Business Name | DAMATO CHIROPRACTIC CENTER OF GLASTONBURY, LLC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 330 NAUBUC AVE
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City | GLASTONBURY
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State | CT
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Zip | 06033-1011
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Country | US
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Telephone | 860-944-8336
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Fax |
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Provider Business Mailing Address
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Address Line | 330 NAUBUC AVE
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City | GLASTONBURY
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State | CT
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Zip | 06033-1011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | NICHOLAS DAMATO
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Credential |
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Telephone | 860-944-8336
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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 | 001822
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License Number State | CT
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