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Organization
HEADZONE LLC
Active
Organization
HEADZONE LLC
Active
Other names
HeadZone Concussion Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY CARRASQUILLO (OFFICE MANAGER)
(203) 527-3181
Entity
Organization
Contact information
Practice address
1389 W MAIN ST, SUITE 325, WATERBURY, CT 06708-3104
(203) 527-3181
Mailing address
1389 W MAIN ST, SUITE 325, WATERBURY, CT 06708-3104
(203) 527-3181
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
CLPOL0098
CT
261QM2500X
Medical Specialty Clinic/Center
Primary
CLPOL0098
CT
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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