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Individual

ROBERT M SHORTELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
28 SHUNPIKE RD, CROMWELL, CT 06416-2454
(860) 635-4455
(860) 635-0499
Mailing address
4 BREEZY CORNERS RD, PORTLAND, CT 06480-1711
(860) 342-1636

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001242
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004178035
CT
Enumeration date
07/11/2005
Last updated
07/08/2007
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