Individual
MICHELLE RENEE LA FORTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8 FOOT CT, WATERFORD, CT 06385-2712
(860) 391-2828
Mailing address
8 FOOT CT, WATERFORD, CT 06385-2712
(860) 391-2828
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000419
CT
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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