Kevin Keith Bodling, D.C.
Individual provider Active NPI Internist Chiropractor · Washington Depot, CT
NPI 1992087209 · NPPES record last updated Sep 13, 2011
Key facts
- NPI
- 1992087209
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internist Chiropractor 111NI0900X
- License
- 1798 (CT)
- Practice address
- 1 Titus Rd
Suite 2
Washington Depot, CT 06794-1516 - Phone
- (888) 852-2723
- NPI assigned
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1798 | CT | MD | Internist Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 1798 | CT | Yes |
Addresses
Primary practice location
1 Titus Rd
Suite 2
Washington Depot, CT 06794-1516
Mailing address
PO Box 337
Washington Depot, CT 06794-0337
Other providers in Washington Depot, CT
- Connecticut Therapy Associates, LLC
- Doctors Choice Professional Laboratory & Diagnostic Services, Inc.
- John P Ewing
- Judith Gorra
- Allan Herbert Grunberg
All providers in Washington Depot, CT · Internist Chiropractor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.