Healthcare Provider Details

I. General information

NPI: 1629132766
Provider Name (Legal Business Name): JOSEPH JAMES NEAL DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 WELLES ST SUITE 207
GLASTONBURY CT
06033
US

IV. Provider business mailing address

49 WELLES ST SUITE 207
GLASTONBURY CT
06033
US

V. Phone/Fax

Practice location:
  • Phone: 860-633-3525
  • Fax: 860-633-7186
Mailing address:
  • Phone: 860-633-3525
  • Fax: 860-633-7186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number000167
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number167
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: