NPI | 1114533429 |
---|---|
Former Legal Business Name | ACTIVE CHIRO LLC |
Entity Type | Organization |
Authorized Contact | MICHAEL ANTHONY SIMEOLI Owner 203-928-9455 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Enumeration Date | 2020-09-22 |
Last Update Date | 2023-07-31 |