| NPI | 1194112490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI FUSCO Manager 203-573-8577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CT 00196) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CT 001584) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2021-05-25 |