Provider Demographics
NPI:1124452560
Name:PLAINFIELD FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:PLAINFIELD FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WORSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-317-1212
Mailing Address - Street 1:36 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06374-1217
Mailing Address - Country:US
Mailing Address - Phone:860-317-1212
Mailing Address - Fax:860-317-1379
Practice Address - Street 1:36 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:CT
Practice Address - Zip Code:06374-1217
Practice Address - Country:US
Practice Address - Phone:860-317-1212
Practice Address - Fax:860-317-1379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT001267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty