MEDICARE: BLOOMFIELD ADVANCED NECK & BACK CARE

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	001139	CT

General Provider Information

NPI Number	:	1831200989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOMFIELD ADVANCED NECK & BACK CARE

Provider Business Mailing Address
First Line	:	1 NORTHWESTERN DR
Second Line	:	SUITE 204
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3400
Country	:	US
Telephone Number	:	860-243-5815
Fax Number	:	860-761-6677

Provider Business Practice Location Address
First Line	:	1 NORTHWESTERN DR
Second Line	:	SUITE 204
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3400
Country	:	US
Telephone Number	:	860-243-5818
Fax Number	:	860-761-6677

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ELAINE POMPA
Credential	:	DC
Telephone Number	:	860-243-5815

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/22/2020

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Directions to “BLOOMFIELD ADVANCED NECK & BACK CARE ” Practice Location

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