Provider Demographics
NPI:1902283062
Name:STRATFORD ACUPUNCTURE & WELLNESS CENTER
Entity Type:Organization
Organization Name:STRATFORD ACUPUNCTURE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:203-257-7550
Mailing Address - Street 1:95 ARMORY RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1753
Mailing Address - Country:US
Mailing Address - Phone:203-257-7550
Mailing Address - Fax:888-941-0005
Practice Address - Street 1:95 ARMORY RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1753
Practice Address - Country:US
Practice Address - Phone:203-257-7550
Practice Address - Fax:888-941-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT534171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty