Provider Demographics
NPI:1871784108
Name:ECKERT CHIROPRACTIC, P.C.
Entity type:Organization
Organization Name:ECKERT CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:ECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-889-1475
Mailing Address - Street 1:598 W MAIN ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5342
Mailing Address - Country:US
Mailing Address - Phone:860-889-1475
Mailing Address - Fax:860-889-1850
Practice Address - Street 1:598 W MAIN ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5342
Practice Address - Country:US
Practice Address - Phone:860-889-1475
Practice Address - Fax:860-889-1850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTT01350Medicare UPIN