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Individual

DR. JOHN LOUIS MORMILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
234 MAIN ST, PORTLAND, CT 06480-1861
(860) 342-7277
(860) 342-7281
Mailing address
234 MAIN ST, PORTLAND, CT 06480-1861
(860) 342-7277
(860) 342-7281

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
540
CT
111N00000X
Chiropractor
CH0004991
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050000540CT03
ANTHEM
CT
01
061632199-01
PRISM
CT
01
2V0679
HEALTHNET
CT
01
4212157
AETNA
CT
01
CT00540
LANDMARK
01
NHS338
OXFORD
CT
Enumeration date
08/16/2005
Last updated
03/24/2008
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