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Organization
CONNECTICUT LYMPHATIC THERAPY AND SUPPLIES, LLC
Active
Organization
CONNECTICUT LYMPHATIC THERAPY AND SUPPLIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE-JEAN CONNAL (MANAGER, CT LYMPHATIC)
(203) 907-7031
Entity
Organization
Contact information
Practice address
80 SHUNPIKE RD UNIT 101A, CROMWELL, CT 06416-4402
(203) 907-7031
Mailing address
80 SHUNPIKE RD UNIT 101A, CROMWELL, CT 06416-4402
(203) 907-7031
(860) 343-0788
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
502651
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8950503-000
CT TAX ID
CT
Enumeration date
09/26/2008
Last updated
11/10/2022
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