Stafford Family Chiropractic, LLC
Organization Active NPI Chiropractor · Stafford Springs, CT
NPI 1508030487 · NPPES record last updated Feb 12, 2014
Key facts
- NPI
- 1508030487
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- STAFFORD FAMILY CHIROPRACTIC, LLC
- Practice address
- 72 West Stafford Road
Suite a-3
Stafford Springs, CT 06076 - Phone
- (860) 684-2227
- Fax
- (860) 684-6104
- NPI assigned
- Apr 22, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Gabriel John Thayer, D.C.
- Title
- Owner/Member
- Phone
- (860) 684-2227
Practitioners 1
-
Gabriel John Thayer, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080606000706 | CT | Part B Supplier - Clinic/Group Practice | 4880764570 |
Receives reassigned benefits from 1 practitioner Practice locations: Stafford Springs, CT |
National Provider Directory
Locations
72 W Stafford Rd
Unit A3
Stafford Springs, CT 06076
Phone (860) 684-2227
32 W Stafford Rd
Stafford Springs, CT 06076
Phone (860) 684-2227
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
72 West Stafford Road
Suite a-3
Stafford Springs, CT 06076
Mailing address
P.O. Box 110
Stafford Springs, CT 06076
Phone (860) 684-2227
Other providers in Stafford Springs, CT
- Desh R Sindwani
- Deanna Marie Soja
- Somers Anesthesiology Associates
- Stafford Ambulance Association Inc.
- Stafford Dental Associates LLC
- Stafford Family Services
- Stafford Public Schools
- Stafford Springs CT SNF LLC
- Desirae Tabor-Bannister
- Naufel Tajudeen
All providers in Stafford Springs, CT · Chiropractor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.