Provider Demographics
NPI:1528315637
Name:CONNELLY, CHRISTINA ANN (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ANN
Last Name:CONNELLY
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 1:98 WHITING ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2881
Mailing Address - Country:US
Mailing Address - Phone:860-846-0993
Mailing Address - Fax:860-846-0998
Practice Address - Street 1:98 WHITING ST UNIT C
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:CT
Practice Address - Zip Code:06062-2881
Practice Address - Country:US
Practice Address - Phone:860-846-0993
Practice Address - Fax:860-846-0998
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor