Individual
DR. MARTIN DESOMMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
276 HIGHLAND AVE, WATERBURY, CT 06708-3022
(203) 753-6384
(203) 759-1705
Mailing address
276 HIGHLAND AVE, WATERBURY, CT 06708-3022
(203) 753-6384
(203) 759-1705
Taxonomy
Speciality
Code
Description
License number
State
111NX0100X
Occupational Health Chiropractor
Primary
554
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069530
—
CT
01
—
050000554CT01
ANTHEM BLUE CROSS BLUE SH
CT
Enumeration date
05/31/2005
Last updated
02/09/2010
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