Provider Demographics
NPI:1932477585
Name:SANJURJO, TOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:
Last Name:SANJURJO
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 1:290 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3684
Mailing Address - Country:US
Mailing Address - Phone:860-290-3788
Mailing Address - Fax:860-290-3789
Practice Address - Street 1:290 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3684
Practice Address - Country:US
Practice Address - Phone:860-290-3788
Practice Address - Fax:860-290-3789
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor