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General NPI Number Information
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NPI Number | 1386984417
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Entity Type | Organization
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Legal Business Name | GLASTONBURY NATUROPATHIC CENTER LLC
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 18 SCHOOL ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2241
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Country | US
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Telephone | 860-657-4105
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Fax |
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Provider Business Mailing Address
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Address Line | 18 SCHOOL ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2241
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Country | US
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Telephone | 860-657-4105
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. HELENE PULNIK
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Credential | ND
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Telephone | 86065674105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 000235
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License Number State | CT
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