Provider Demographics
NPI:1114565033
Name:WALTZER, DAVID CRAIG (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CRAIG
Last Name:WALTZER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 FEDERAL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-4099
Mailing Address - Country:US
Mailing Address - Phone:203-778-2225
Mailing Address - Fax:203-778-0591
Practice Address - Street 1:132 FEDERAL RD STE 103
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-4099
Practice Address - Country:US
Practice Address - Phone:203-778-2225
Practice Address - Fax:203-778-0591
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor