Individual
JACK RICHARD KINSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1 EMILY WAY, WEST HARTFORD, CT 06107-3136
(860) 561-7022
Mailing address
4 BRIGHTVIEW DR, WEST HARTFORD, CT 06117-2001
(860) 233-3041
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000710
CT
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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