MEDICARE: BRISTOL CHIROPRACTIC & ACUPUNCTURE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1255765525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRISTOL CHIROPRACTIC & ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	162 SOUTH ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-6505
Country	:	US
Telephone Number	:	860-585-9797
Fax Number	:	860-589-9002

Provider Business Practice Location Address
First Line	:	162 SOUTH ST
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-6505
Country	:	US
Telephone Number	:	860-585-9797
Fax Number	:	860-589-9002

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. GLEN MICHAEL PALMISANO
Credential	:	D.C.
Telephone Number	:	860-585-9797

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	11/01/2024

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