Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 002070 | CT |
NPI | 1003419292 |
---|---|
Provider Name | Craig A. Cameron |
First Address | West Haven, CT 06516 |
Second Address | West Haven, CT 06516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2020 |
Last Update Date | 19/11/2020 |