Individual
LISA O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
45 MERIDEN AVE, SOUTHINGTON, CT 06489-3214
(860) 378-1234
Mailing address
32 SUNNYBROOK DR, MANCHESTER, CT 06040-6622
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001560
CT
Other
Enumeration date
06/14/2015
Last updated
06/14/2015
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