Provider Demographics
NPI:1518099043
Name:LITCHMAN, CHERYL G (DC)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:G
Last Name:LITCHMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3620
Mailing Address - Country:US
Mailing Address - Phone:203-877-9323
Mailing Address - Fax:203-877-5617
Practice Address - Street 1:606 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3620
Practice Address - Country:US
Practice Address - Phone:203-877-9323
Practice Address - Fax:203-877-5617
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000291Medicare ID - Type UnspecifiedPROVIDER ID