Provider Demographics
NPI:1417050014
Name:POWERS, PAUL D (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:POWERS
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:PO BOX 15
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067
Mailing Address - Country:US
Mailing Address - Phone:860-257-7448
Mailing Address - Fax:860-257-9574
Practice Address - Street 1:2080 SILAS DEANE HWY
Practice Address - Street 2:3RD FLOOR
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2334
Practice Address - Country:US
Practice Address - Phone:860-257-7448
Practice Address - Fax:860-257-9574
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004121349Medicaid
T22208Medicare UPIN
350001070Medicare ID - Type Unspecified