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General NPI Number Information
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NPI Number | 1740498393
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Entity Type | Organization
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Legal Business Name | SPORT HILL CHIROPRACTIC
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 267 SPORT HILL RD
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City | EASTON
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State | CT
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Zip | 06612-1825
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Country | US
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Telephone | 203-371-6004
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Fax | 203-372-2379
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Provider Business Mailing Address
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Address Line | 267 SPORT HILL RD
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City | EASTON
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State | CT
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Zip | 06612-1825
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Country | US
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Telephone | 203-371-6004
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Fax | 203-372-2379
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY TORTORELLA
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Credential | D.C.
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Telephone | 203-371-6004
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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 | 001542
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License Number State | CT
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