MEDICARE: CENTER FOR NATURAL WELLNESS

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	111NN1001X	Nutrition Chiropractor
2	111NP0017X	Pediatric Chiropractor
3	111NR0400X	Rehabilitation Chiropractor
4	111NS0005X	Sports Physician Chiropractor
5	171100000X	Acupuncturist
6	111N00000X	Chiropractor	001489	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1689973059	OTHER		INDIVIDUAL NPI

General Provider Information

NPI Number	:	1689088395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR NATURAL WELLNESS

Provider Business Mailing Address
First Line	:	166 ALBANY TPKE
Second Line	:	SUITE 10
City	:	CANTON
State	:	CT
Zip	:	06019-2546
Country	:	US
Telephone Number	:	860-693-0255
Fax Number	:	860-693-4250

Provider Business Practice Location Address
First Line	:	166 ALBANY TPKE
Second Line	:	SUITE 10
City	:	CANTON
State	:	CT
Zip	:	06019-2546
Country	:	US
Telephone Number	:	860-693-0255
Fax Number	:	860-693-4250

Authorized Official
Title or Position	:	CHIROPRACTOR AND ACUPUNCTURIST
Name	:	DR. STEPHEN R KARPENKO
Credential	:	MD, ACCP
Telephone Number	:	860-693-0255

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	06/20/2014

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Directions to “CENTER FOR NATURAL WELLNESS ” Practice Location

Language	Start Address	Practice Location

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