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NPI 1851790711

NPI 1851790711 : MUSCULOSKELETAL HEALTH CENTERS LLC : WEATOGUE, CT

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General NPI Number Information
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    NPI Number           |    1851790711
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    Entity Type          |    Organization 
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    Legal Business Name  |    MUSCULOSKELETAL HEALTH CENTERS LLC 
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Dates
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    Enumeration Date     |    08/17/2014
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    Last Update Date     |    10/06/2014
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Provider Practice Location Address
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    Address Line         |    381 HOPMEADOW ST STE 303 
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    City                 |    WEATOGUE
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    State                |    CT
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    Zip                  |    06089-9697
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    Country              |    US
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    Telephone            |    860-413-2547
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    381 HOPMEADOW ST STE 303 
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    City                 |    WEATOGUE
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    State                |    CT
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    Zip                  |    06089-9697
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    Country              |    US
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    Telephone            |    860-413-2547
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. MICHAEL CHIKEZIE IJOMAH 
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    Credential           |    DC
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    Telephone            |    860-413-2547
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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       |    
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    License Number State |    
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