Individual
KENNETH LANDRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
546 ENFIELD ST, ENFIELD, CT 06082-2408
(860) 265-3792
Mailing address
546 ENFIELD ST, ENFIELD, CT 06082-2408
(860) 265-3792
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001461
CT
111N00000X
Chiropractor
2225
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y36882
BLUECROSS BLUESHIELD
MA
Enumeration date
05/13/2006
Last updated
07/09/2007
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