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LINDA M BRUSTOLON LPTA
>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1174790307
Individual Registrant: LINDA M BRUSTOLON LPTA
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
475 HIGH ST MYSTIC, CT 06355-1707 US
Tel: 860-536-6070 Fax: 860-536-9480
Tel: 860-536-6070 Fax: 860-536-9480
Contact information for business:
475 HIGH ST MYSTIC, CT 06355-1707 US
Tel: 860-536-6070 Fax: 860-536-9480
Tel: 860-536-6070 Fax: 860-536-9480
Registration Information:
NPI: 1174790307
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapy Assistant | CT | 000069 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
