Provider Demographics
NPI:1023251097
Name:CENTER FOR ALTERNATIVE MEDICINE, P.C.
Entity type:Organization
Organization Name:CENTER FOR ALTERNATIVE MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:L
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:860-567-5727
Mailing Address - Street 1:286 TORRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-2725
Mailing Address - Country:US
Mailing Address - Phone:860-567-5727
Mailing Address - Fax:860-567-2667
Practice Address - Street 1:286 TORRINGTON RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2725
Practice Address - Country:US
Practice Address - Phone:860-567-5727
Practice Address - Fax:860-567-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001136111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000833Medicare PIN