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General NPI Number Information
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NPI Number | 1770702870
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC AND REHABILITATION CENTER OF CHESHIRE INC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 441 MAPLE AVE
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City | CHESHIRE
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State | CT
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Zip | 06410-2141
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Country | US
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Telephone | 203-272-0573
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Fax |
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Provider Business Mailing Address
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Address Line | 441 MAPLE AVE
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City | CHESHIRE
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State | CT
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Zip | 06410-2141
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Country | US
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Telephone | 203-272-0573
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICOLE A GALIETTE
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Credential | D.C.
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Telephone | 203-272-8960
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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 | 0001254
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License Number State | CT
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