Individual
MS. TRACEY HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
220 SCOVILLE RD, AVON, CT 06001-2515
(860) 677-2934
Mailing address
220 SCOVILLE RD, AVON, CT 06001-2515
(860) 677-2934
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1102
CT
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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