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KELLY DETWILER ATC,CSCS

>> Specialist >> Other Service Providers

Registrant NPI Number: 1437203577

Individual Registrant:
 KELLY  DETWILER ATC,CSCS
Gender: F
Sole Proprietor

Location and contact information for practice:
40 BULLS BRIDGE RD  SOUTH KENT, CT 06785-1118 US
Tel: 860-927-3539  Fax: --

Contact information for business:
4 PASTURE WAY  NEW MILFORD, CT 06776-5632 US
Tel: --  Fax: --

Registration Information:
NPI: 1437203577
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
CT

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CT - Page 1



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