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Individual

LAUREN STODDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
29 HIGHLAND ST, WEST HARTFORD, CT 06119-1398
(860) 236-5623
Mailing address
46 BELLAIRE MNR, CROMWELL, CT 06416-2105

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001802
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001802
DPH
CT
Enumeration date
03/03/2021
Last updated
03/03/2021
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