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General NPI Number Information
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NPI Number | 1932549953
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Entity Type | Organization
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Legal Business Name | DR BRIAN P CONNER LLC
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 366 FEDERAL RD
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City | BROOKFIELD
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State | CT
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Zip | 06804-2406
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Country | US
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Telephone | 203-775-1819
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Fax | 203-775-2028
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Provider Business Mailing Address
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Address Line | 366 FEDERAL RD
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City | BROOKFIELD
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State | CT
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Zip | 06804-2406
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Country | US
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Telephone | 203-775-1819
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Fax | 203-775-2028
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Authorized Official
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Title or Position | MEMBER
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Name | DR. BRIAN PATRICK CONNER
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Credential | DC, CNS, CDN
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Telephone | 203-775-1819
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 1485
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License Number State | CT
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Taxonomy #2
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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 | CT
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