Individual
DR. MARY E POWELL ST LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
512 SAYBROOK RD, SUITE 100, MIDDLETOWN, CT 06457-4788
(860) 347-7636
(860) 894-1882
Mailing address
512 SAYBROOK RD, SUITE 100, MIDDLETOWN, CT 06457-4788
(860) 347-7636
(860) 894-1882
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036668
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001366683
—
CT
Enumeration date
10/16/2006
Last updated
01/11/2010
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