Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 0001940 | CT |
NPI | 1386821585 |
---|---|
Provider Name | Dr. Daniel M. Terray JR. |
First Address | Old Saybrook, CT 06475-4420 |
Second Address | Old Saybrook, CT 06475-4420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2008 |
Last Update Date | 30/01/2008 |