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STEVEN BANDTLOW MS, ATC

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1457998510

Individual Registrant:
 STEVEN  BANDTLOW MS, ATC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
270 MOHEGAN AVE  NEW LONDON, CT 06320-4125 US
Tel: 806-439-2086  Fax: --

Contact information for business:
955 GLASTONBURY TPKE  PORTLAND, CT 06480-1029 US
Tel: 860-550-2924  Fax: --

Registration Information:
NPI: 1457998510
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
CT000813

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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