Provider Demographics
NPI:1992168199
Name:HEALING HANDS CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:HEALING HANDS CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MALTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-626-9994
Mailing Address - Street 1:100 CENTER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4112
Mailing Address - Country:US
Mailing Address - Phone:203-626-9994
Mailing Address - Fax:203-284-3677
Practice Address - Street 1:100 CENTER ST STE 100
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-4112
Practice Address - Country:US
Practice Address - Phone:203-626-9994
Practice Address - Fax:203-284-3677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT57727935-000OtherCT REGISTRATION
CT1013180512OtherINDIVIDUAL NPI
CT1013180512OtherINDIVIDUAL NPI