Provider Demographics
NPI:1649257130
Name:MCLAMORE, AUTUMN NICOLE (DC)
Entity type:Individual
Prefix:DR
First Name:AUTUMN
Middle Name:NICOLE
Last Name:MCLAMORE
Suffix:
Gender:
Credentials:DC
Other - Prefix:DR
Other - First Name:AUTUMN
Other - Middle Name:NICOLE
Other - Last Name:CUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:15 WARRINGTON ROUND
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5170
Mailing Address - Country:US
Mailing Address - Phone:646-943-1769
Mailing Address - Fax:
Practice Address - Street 1:15 WARRINGTON ROUND
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5170
Practice Address - Country:US
Practice Address - Phone:646-943-1769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ36MC00635000111N00000X
NYX0108462111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor