| Milford Sport & Spine Llc | |
|
213 New Haven Ave Fl 1 Milford CT 06460-4830 | |
| (203) 783-9720 | |
| Not Available |
| Full Name | Milford Sport & Spine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 213 New Haven Ave Fl 1, Milford, Connecticut |
| Authorized Official Name and Position | Edmond Michael Daniells (OWNER/CHIROPRACTOR) |
| Authorized Official Contact | 2035892782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milford Sport & Spine Llc 552 Treat Ln Orange CT 06477-2740 Ph: () - | Milford Sport & Spine Llc 213 New Haven Ave Fl 1 Milford CT 06460-4830 Ph: (203) 783-9720 |
| NPI Number | 1811717457 |
|---|---|
| Provider Enumeration Date | 10/16/2024 |
| Last Update Date | 01/24/2025 |
| Medicare PECOS PAC ID | 4082144167 |
|---|---|
| Medicare Enrollment ID | O20250204002607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811717457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Edmund M Daniells |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1871901132 PECOS PAC ID: 6002103058 Enrollment ID: I20160920000832 |
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