Provider Demographics
NPI:1437336518
Name:GREGOR, TED (DC)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:
Last Name:GREGOR
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 1:30 PECK RD
Mailing Address - Street 2:SUITE 1103-A
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-6123
Mailing Address - Country:US
Mailing Address - Phone:860-489-1800
Mailing Address - Fax:860-489-1800
Practice Address - Street 1:30 PECK RD
Practice Address - Street 2:SUITE 1103-A
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6123
Practice Address - Country:US
Practice Address - Phone:860-489-1800
Practice Address - Fax:860-489-1800
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor