Individual
KRISTINA BACCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2015 W MAIN ST, STAMFORD, CT 06902-4536
(203) 863-2880
Mailing address
9 PURDY RD, NORWALK, CT 06850-1409
(203) 943-0102
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
010821
CT
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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