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General NPI Number Information
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NPI Number | 1760433494
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Entity Type | Individual
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Provider Name | KRISTIN M. RAYBALL D.C., C.C.S.P.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 340 POST RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6220
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Country | US
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Telephone | 203-259-3210
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Fax | 203-259-3213
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Provider Business Mailing Address
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Address Line | 340 POST RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6220
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Country | US
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Telephone | 203-259-3210
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Fax | 203-259-3213
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 1556
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License Number State | CT
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