Provider Demographics
NPI:1528001435
Name:CLUKEY, DAVID ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANTHONY
Last Name:CLUKEY
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 1:2 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-2213
Mailing Address - Country:US
Mailing Address - Phone:203-949-1777
Mailing Address - Fax:203-949-9342
Practice Address - Street 1:2 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2213
Practice Address - Country:US
Practice Address - Phone:203-949-1777
Practice Address - Fax:203-949-9342
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCT0247OtherLANDMARK
CT050000247CT02OtherANTHEM BC/BS
CTP1297266OtherOXFORD
CT2141354OtherAETNA HEALTH PLANS
CT050000247CT02OtherANTHEM BC/BS