Provider Demographics
NPI:1023221710
Name:STRAWBERRY HILL CHIROPRACTIC PC
Entity type:Organization
Organization Name:STRAWBERRY HILL CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMOLANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-325-2990
Mailing Address - Street 1:ONE STRAWBERRY HILL COURT
Mailing Address - Street 2:STE L4
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:203-325-2990
Mailing Address - Fax:203-353-9572
Practice Address - Street 1:ONE STRAWBERRY HILL COURT
Practice Address - Street 2:STE L4
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-325-2990
Practice Address - Fax:203-353-9572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000783CT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty