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MYSTIC SPINE & SPORT LLC
NPI 1952692592
Chiropractor in Mystic, CT

Active since May 01, 2011
12 COOGAN BLVD STE 204, MYSTIC, CT 06355(860) 245-4620(860) 245-5752 Get Directions Write a Review

NPPES record last updated: February 2, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mystic Spine & Sport Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYSTIC SPINE & SPORT LLC (NPI 1952692592) is a healthcare organization registered as a chiropractor in Mystic, Connecticut and active in the NPI registry since May 2011. The organization lists Tyler Curtis Page, Owner/doctor, as its authorized official.

NPPES Registry Identity

NPI1952692592
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameMYSTIC SPINE & SPORT LLC
Location Address12 COOGAN BLVD STE 204Mystic, CT 06355-1938
Mailing Address12 Coogan Blvd Ste 204Mystic, CT 06355-1938 · (860) 245-4620 · Fax (860) 245-5752
Phone(860) 245-4620
Fax(860) 245-5752
Organization SubpartNo
Authorized OfficialTyler Curtis PageOwner/doctor · (860) 245-4620
Enumeration DateMay 1, 2011
Last NPPES UpdateFebruary 2, 2024
NPPES CertifiedFebruary 2, 2024
✔ NPI 1952692592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
12 COOGAN BLVD STE 204, Mystic, CT 06355
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TYLER CURTIS PAGE D.C.
Chiropractor (Rehabilitation)
12 COOGAN BLVD STE 204
MYSTIC, CT 06355
Southeastern Connecticut Planning Region (860) 245-4620
KATHYS BREASTFEEDING NOOK
Registered Nurse (Lactation Consultant)
12 COOGAN BLVD STE 204
MYSTIC, CT 06355
Southeastern Connecticut Planning Region (860) 705-5663

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mystic Spine & Sport LLC's NPI number?

The NPI number for Mystic Spine & Sport LLC is 1952692592. It was assigned to this organization in the NPPES registry on May 1, 2011.

Where is Mystic Spine & Sport LLC located?

Mystic Spine & Sport LLC is located at 12 Coogan Blvd Ste 204, Mystic, CT 06355. The listed phone number is (860) 245-4620.

What is Mystic Spine & Sport LLC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

When was this NPI record last updated?

The NPPES record for Mystic Spine & Sport LLC was last updated on February 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.