MEDICARE: CHIROPRACTIC AND REHABILITATION CENTER OF CHESHIRE INC

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	0001254	CT

General Provider Information

NPI Number	:	1770702870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC AND REHABILITATION CENTER OF CHESHIRE INC

Provider Business Mailing Address
First Line	:	441 MAPLE AVE
Second Line	:
City	:	CHESHIRE
State	:	CT
Zip	:	06410-2141
Country	:	US
Telephone Number	:	203-272-0573
Fax Number	:

Provider Business Practice Location Address
First Line	:	441 MAPLE AVE
Second Line	:
City	:	CHESHIRE
State	:	CT
Zip	:	06410-2141
Country	:	US
Telephone Number	:	203-272-0573
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NICOLE A GALIETTE
Credential	:	D.C.
Telephone Number	:	203-272-8960

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	06/03/2014

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