Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 000278 | CT |
NPI | 1417081928 |
---|---|
Provider Name | Dr. Curt Glenn Riebeling |
First Address | Newtown, CT 06470-2045 |
Second Address | Newtown, CT 06470-2045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T-22005 | (02) | CT |