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General NPI Number Information
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NPI Number | 1780182774
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Entity Type | Individual
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Provider Name | KENNETH GERARD GUERIN DC
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Gender | Male
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 256 POST RD E
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City | WESTPORT
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State | CT
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Zip | 06880-3620
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Country | US
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Telephone | 203-247-9320
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Fax | 203-247-9320
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Provider Business Mailing Address
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Address Line | 19 TIMBER MILL LN
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City | WESTON
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State | CT
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Zip | 06883-2727
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Country | US
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Telephone | 203-247-9320
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2097
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License Number State | CT
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