Provider Demographics
NPI:1336340991
Name:FOUR WINDS CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:FOUR WINDS CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-822-3676
Mailing Address - Street 1:2006 NOOSENECK HILL RD
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-6708
Mailing Address - Country:US
Mailing Address - Phone:401-822-3676
Mailing Address - Fax:401-826-1127
Practice Address - Street 1:2006 NOOSENECK HILL RD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6708
Practice Address - Country:US
Practice Address - Phone:401-822-3676
Practice Address - Fax:401-826-1127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP000436111N00000X
RIDCP000442111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI346820000OtherGROUP # FED WORKER'S COMP