Healthcare Provider Details

I. General information

NPI: 1699027326
Provider Name (Legal Business Name): GAIL M CAULDWELL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 09/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BOSTON POST RD
WATERFORD CT
06385-2819
US

IV. Provider business mailing address

15 MILLSTONE RD
WATERFORD CT
06385-3116
US

V. Phone/Fax

Practice location:
  • Phone: 860-442-3180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number1882
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1882
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: