Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 000677 | CT |
NPI | 1003998402 |
---|---|
Provider Name | Dr. Allen Mclure Maryott |
First Address | Bethany, CT 06524-3530 |
Second Address | Rocky Hill, CT 06067-3163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |