Provider Demographics
NPI:1306262753
Name:SYKES FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:SYKES FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:NQ
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-313-5050
Mailing Address - Street 1:16 MAIN ST
Mailing Address - Street 2:302
Mailing Address - City:DURHAM
Mailing Address - State:CT
Mailing Address - Zip Code:06422-2116
Mailing Address - Country:US
Mailing Address - Phone:860-349-0639
Mailing Address - Fax:
Practice Address - Street 1:16 MAIN ST
Practice Address - Street 2:302
Practice Address - City:DURHAM
Practice Address - State:CT
Practice Address - Zip Code:06422-2116
Practice Address - Country:US
Practice Address - Phone:860-349-0639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty