Provider Demographics
NPI:1194091561
Name:COLBY FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:COLBY FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-521-3949
Mailing Address - Street 1:48 WYNDEMERE LN
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1178
Mailing Address - Country:US
Mailing Address - Phone:949-521-3949
Mailing Address - Fax:
Practice Address - Street 1:220 HARTFORD TPKE STE 2
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4700
Practice Address - Country:US
Practice Address - Phone:860-871-0616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty