Provider Demographics
NPI:1871619056
Name:CONNECTICUT CHIROPRACTIC SPECIALISTS LLC
Entity type:Organization
Organization Name:CONNECTICUT CHIROPRACTIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:FORTE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-562-8600
Mailing Address - Street 1:397 BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4151
Mailing Address - Country:US
Mailing Address - Phone:203-562-8600
Mailing Address - Fax:203-874-5287
Practice Address - Street 1:397 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-4151
Practice Address - Country:US
Practice Address - Phone:203-562-8600
Practice Address - Fax:203-874-5287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03187Medicare ID - Type Unspecified