Provider Demographics
NPI:1104262260
Name:CUTTING, RICHARD GORDON (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:GORDON
Last Name:CUTTING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OLD SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-3023
Mailing Address - Country:US
Mailing Address - Phone:860-836-1779
Mailing Address - Fax:
Practice Address - Street 1:93 MARKET SQ
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2900
Practice Address - Country:US
Practice Address - Phone:860-436-2065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001942111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor