Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 001003 | CT |
N | 111NR0400X | Rehabilitation Chiropractor | X006928 | NY |
NPI | 1144344938 |
---|---|
Provider Name | Dr. Pamela Welch Tunnell |
First Address | Ridgefield, CT 06877-5913 |
Second Address | Ridgefield, CT 06877-5913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U54401 | (02) | CT |