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MR. FREDERICK MASON PHELPS PT

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

Registrant NPI Number: 1841209855

Individual Registrant:
MR. FREDERICK MASON PHELPS PT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2B LEE RD  LISBON, CT 06351-3042 US
Tel: 860-376-2564  Fax: 860-376-4812

Contact information for business:
2B LEE RD  LISBON, CT 06351-3042 US
Tel: 860-376-2564  Fax: 860-376-4812

Registration Information:
NPI: 1841209855
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CT003524

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBS080003524CT01CT01
004066973CT05




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