Connecticut Sports Clinic Llc

LBN: Connecticut Sports Clinic Llc
Connecticut Sports Clinic Llc is an health care organization with primary practice located at 129 Church St Fl 1 , New Haven CT 06510-2026. The organization recently has only one registered license in Ambulatory Health Care Facilities / Physical Therapy, which is considered as the primary health care specialty. Connecticut Sports Clinic Llc can be contacted via phone (203) 200-0099, or through Hom, Gregory via phone (203) 589-0226.

Contact Information

Primary practice address
129 Church St Fl 1 New Haven CT 06510-2026
Phone: (203) 200-0099
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hom, Gregory Doctor of Chiropractic (DC)
Phone: (203) 589-0226

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X 2028 Connecticut

Profile Details

NPI number 1598258519
LBN Legal business name Connecticut Sports Clinic Llc
DBA Doing business as
Authorized official Hom, Gregory Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 13th, 2018
Last updated Sep 24th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598258519 NPPES
Connecticut MEDICAID 1174912125

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