Provider Demographics
NPI:1972717874
Name:PAWSON, MARY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:PAWSON
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 1:40 PATRICIA LN
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-1045
Mailing Address - Country:US
Mailing Address - Phone:203-879-9902
Mailing Address - Fax:203-879-1909
Practice Address - Street 1:40 PATRICIA LN
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-1045
Practice Address - Country:US
Practice Address - Phone:203-879-9902
Practice Address - Fax:203-879-1909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor