| Organization Name: | PHYSICAL MEDICINE AND CHIROPRACTIC CENTER LORELEI DAVIDSON M.D. MARC K |
| NPI Number: | 1023102209 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC DAVID KIRSHNER (PRESIDENT) |
| Mailing Address: | 1867 Summer St Stamford |
| State: | CT US |
| Postal Code: | 069055016 |
| Phone Number: | 2039757000 |
| Fax Number: | 2039750876 |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 03/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204C00000X |
| License Number: | 044106 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine, Sports Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |