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BIANCA BOLDUC

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1275075285

Individual Registrant:
 BIANCA  BOLDUC 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
382 S MAIN ST  CHESHIRE, CT 06410 US
Tel: 203-250-9663  Fax: --

Contact information for business:
24422 AVENIDA DE LA CARLOTA STE 100  LAGUNA HILLS, CA 92653-3648 US
Tel: 949-916-1654  Fax: --

Registration Information:
NPI: 1275075285
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CA293176
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CT11191

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
004190328CT05




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