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Individual

MR. JUSTIN MICHAEL SHAY I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.M.T

Contact information

Practice address
2889 FAIRFIELD AVE, BRIDGEPORT, CT 06605-3211
(203) 212-0278
Mailing address
81 NASH LN # 6, BRIDGEPORT, CT 06605-3017
(203) 212-0278

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
006164
CT

Other

Enumeration date
11/15/2011
Last updated
11/15/2011
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