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General NPI Number Information
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NPI Number | 1518369552
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Entity Type | Organization
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Legal Business Name | CUTTING EDGE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 09/22/2014
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Provider Practice Location Address
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Address Line | 387 MERROW RD
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City | TOLLAND
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State | CT
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Zip | 06084-3935
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Country | US
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Telephone | 860-454-0942
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Fax |
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Provider Business Mailing Address
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Address Line | 387 MERROW RD
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City | TOLLAND
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State | CT
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Zip | 06084-3935
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Country | US
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Telephone | 860-454-0942
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD GORDON CUTTING
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Credential | D.C.
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Telephone | 860-454-0942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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