Provider Demographics
NPI:1487682795
Name:GOULDING, THOMAS B (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:GOULDING
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 1:126 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1606
Mailing Address - Country:US
Mailing Address - Phone:860-739-3927
Mailing Address - Fax:860-739-3928
Practice Address - Street 1:126 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1606
Practice Address - Country:US
Practice Address - Phone:860-739-3927
Practice Address - Fax:860-739-3928
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000310OtherLANDMARK
CT050000310CT01OtherANTHEM BC/BS
CT050000310CT01OtherANTHEM BC/BS