Provider Demographics
NPI:1457760498
Name:BRAY, DAVID PAUL (DC, MS, LMT, ACSM-EP)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:BRAY
Suffix:
Gender:M
Credentials:DC, MS, LMT, ACSM-EP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 CITIZENS DR # 19
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1262
Mailing Address - Country:US
Mailing Address - Phone:203-589-5570
Mailing Address - Fax:475-218-4420
Practice Address - Street 1:99 CITIZENS DR # 19
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1262
Practice Address - Country:US
Practice Address - Phone:203-589-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007571225700000X
CT2359111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT12727302OtherAMERICAN SPECIALTY HEALTH