Provider Demographics
NPI:1508356486
Name:GUNN, SPENCER RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:RYAN
Last Name:GUNN
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 1:705 BOSTON POST RD STE C7
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2732
Mailing Address - Country:US
Mailing Address - Phone:203-533-1130
Mailing Address - Fax:203-533-7970
Practice Address - Street 1:705 BOSTON POST RD STE C7
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2732
Practice Address - Country:US
Practice Address - Phone:203-533-1130
Practice Address - Fax:203-533-7970
Is Sole Proprietor?:No
Enumeration Date:2018-05-16
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2147111N00000X
NC4940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor