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Contact Information

ADVANCED SPINE & SPORTS MEDICINE LLC
821 N MAIN STREET EXT
SUITE 110
WALLINGFORD, CT06492-2464
 Phone: 203-265-7900
 Fax: 203-265-7756
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for ADVANCED SPINE SPORTS MEDICINE LLC · (Female)

NPI Number 1265474571
Status Active
Credentials
Entity Individual
Enumeration date 06/12/2006
Last updated 04/15/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT License # 001350
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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