Interstate Chiropractic Shaw Robert N & E M Wagner PTRS
Organization Active NPI Chiropractor · Milldale, CT
NPI 1295912723 · NPPES record last updated Jun 16, 2008
Key facts
- NPI
- 1295912723
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- CT01066 (CT)
- Legal business name
- INTERSTATE CHIROPRACTIC SHAW ROBERT N & E M WAGNER PTRS
- Practice address
- 1783 Meriden Waterbury Turnpike
Milldale, CT 06467-0475 - Phone
- (860) 621-1919
- NPI assigned
- Jan 28, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Shaw, DC
- Title
- Owner
- Phone
- (860) 621-1919
Practitioners 1
-
Robert N Shaw, DC
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CT01066 | CT | Yes |
Addresses
Primary practice location
1783 Meriden Waterbury Turnpike
Milldale, CT 06467-0475
Mailing address
1783 Meriden Waterbury Tpke
Milldale, CT 06467-0475
Phone (860) 621-1919
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050001066CT01 | Other | CT | BC/BS LEGACY PROVIDER ID |
Other providers in Milldale, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.