Shoreline Chiropractic Center, Llc | |
82 Bradley Rd, Madison, CT 06443-2684 | |
(203) 245-2639 | |
Not Available |
Full Name | Shoreline Chiropractic Center, Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 82 Bradley Rd, Madison, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1003178179 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 1155 (Connecticut) | Primary |
Provider Name | John David Mastrobattisto |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1902979263 PECOS PAC ID: 1951566710 Enrollment ID: I20120628000143 |
Provider Name | Jacob R Calder |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1194365239 PECOS PAC ID: 0547696445 Enrollment ID: I20200213001444 |
Mailing Address | Practice Location Address |
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Shoreline Chiropractic Center, Llc 82 Bradley Rd, Madison, CT 06443-2684 Ph: (203) 245-2639 | Shoreline Chiropractic Center, Llc 82 Bradley Rd, Madison, CT 06443-2684 Ph: (203) 245-2639 |
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