Organization
SHORELINE CHIROPRACTIC CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DAVID MASTROBATTISTO D.C. (OWNER/MEMBER)
(203) 245-2639
Entity
Organization
Contact information
Practice address
82 BRADLEY RD, MADISON, CT 06443-2684
(203) 245-2639
Mailing address
82 BRADLEY RD, MADISON, CT 06443-2684
(203) 245-2639
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1155
CT
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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