Provider Demographics
NPI:1396359998
Name:CONNAUGHTY, DANIEL ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:CONNAUGHTY
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 1:85 SACHEM ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-4201
Mailing Address - Country:US
Mailing Address - Phone:860-889-5812
Mailing Address - Fax:860-886-9247
Practice Address - Street 1:85 SACHEM ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-4201
Practice Address - Country:US
Practice Address - Phone:860-889-5812
Practice Address - Fax:860-886-9247
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor