Provider Demographics
NPI:1104961549
Name:LACHOWSKI, CHRISTOPHER ZBIGNIEW (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ZBIGNIEW
Last Name:LACHOWSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-0369
Mailing Address - Country:US
Mailing Address - Phone:860-739-6259
Mailing Address - Fax:860-739-6429
Practice Address - Street 1:15 CHESTERFIELD RD
Practice Address - Street 2:SUITE 206
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1730
Practice Address - Country:US
Practice Address - Phone:869-739-6259
Practice Address - Fax:860-739-6429
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000714111N00000X, 111NN1001X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000714OtherCHIROPRACTIC LICENSE
CT350000901Medicare ID - Type UnspecifiedMEDICARE ID
CT350000858Medicare ID - Type UnspecifiedMEDICARE ID
CTU60638Medicare UPIN