OrganizationActive
Southport Chiropractic Office, P.C.
NPI 1780884973 · Nutrition Chiropractor · Fairfield, CT
Provider details
- NPI number
- 1780884973
- Entity type
- Organization
- Primary specialty
- Nutrition ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Nicholas S. Bogannam Bogannam, President(203) 259-4731
Specialties & taxonomies
Chiropractic Providers
Practice location
1995 Post Rd
Fairfield, CT 06824-5723
Phone: (203) 259-4731
Fax: (203) 259-7319
Approximate (ZIP-level) locationGet directions
Mailing address
1995 Post Rd
Fairfield, CT 06824-5723
Registry dates
- Enumerated
- 2007-07-25
- Last updated
- 2010-11-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.