Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 001637 | CT |
N | 111NR0400X | Rehabilitation Chiropractor | 001637 | CT |
NPI | 1437399904 |
---|---|
Provider Name | Dr. Brian Todd Pollack |
First Address | New Britain, CT 06052-1301 |
Second Address | New Britain, CT 06052-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 04/11/2015 |