Provider Demographics
NPI:1811011067
Name:LEDOUX, DONALD R (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:LEDOUX
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 1:675 EAST ST N
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-1915
Mailing Address - Country:US
Mailing Address - Phone:860-758-7272
Mailing Address - Fax:860-758-7273
Practice Address - Street 1:675 EAST ST N
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-1915
Practice Address - Country:US
Practice Address - Phone:860-758-7272
Practice Address - Fax:860-758-7273
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH286-0497111N00000X
MA2093111N00000X
CT001733111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor