Individual
MABELLE TEODORO MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
175 JEFFERSON ST, FAIRFIELD, CT 06825-1078
(203) 365-6443
(203) 396-1046
Mailing address
175 JEFFERSON ST, FAIRFIELD, CT 06825-1078
(203) 365-6443
(203) 396-1046
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
0007457
CT
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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