Provider Demographics
NPI:1982327292
Name:INVIGORATE CHIROPRACTIC AND WELLNESS
Entity type:Organization
Organization Name:INVIGORATE CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-277-1222
Mailing Address - Street 1:40 GLEN STREET
Mailing Address - Street 2:2ND FL, STE 1
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-277-1222
Mailing Address - Fax:516-629-6667
Practice Address - Street 1:40 GLEN STREET
Practice Address - Street 2:2ND FL, STE 1
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:516-277-1222
Practice Address - Fax:516-629-6667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty