Provider Demographics
NPI:1508254863
Name:BRETON, JOSEPH ALBERT (ND)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:BRETON
Suffix:
Gender:M
Credentials:ND
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 177
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-0177
Mailing Address - Country:US
Mailing Address - Phone:860-992-2810
Mailing Address - Fax:
Practice Address - Street 1:78 HIGHLAND TER
Practice Address - Street 2:
Practice Address - City:STAFFORD SPRINGS
Practice Address - State:CT
Practice Address - Zip Code:06076-1503
Practice Address - Country:US
Practice Address - Phone:860-992-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000202175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath