Individual
DR. HALID DERVISEVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
36 WOODLAND ST, HARTFORD, CT 06105-2325
(860) 522-2717
(860) 240-7605
Mailing address
77 GOODRICH ST, HARTFORD, CT 06114-2613
(717) 422-6171
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14613
CT
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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