Individual
RUSSELL J BODURTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
292 SPIELMAN HWY, BURLINGTON, CT 06013-1727
(860) 404-2924
(860) 404-2933
Mailing address
465 WOLCOTT RD, WOLCOTT, CT 06716-2613
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11630
CT
Other
Enumeration date
10/04/2017
Last updated
10/04/2017
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