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Individual

MR. THOMAS WAYNE HOLTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.S. A.T.,C

Contact information

Practice address
83 WINDHAM ST, WILLIMANTIC, CT 06226-2211
(860) 465-5171
(860) 465-4696
Mailing address
77 DEER RUN RD, WINDHAM, CT 06280-1535
(860) 450-0893

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
255A2300X
CT

Other

Enumeration date
09/22/2006
Last updated
07/08/2007
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