Individual
RAYMOND A SHAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
14 JONES HOLLOW RD STE 7, MARLBOROUGH, CT 06447-1448
(860) 295-8188
(860) 295-8976
Mailing address
14 JONES HOLLOW RD STE 7, MARLBOROUGH, CT 06447-1448
(860) 295-8188
(860) 295-8976
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3673
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004111671
—
CT
01
—
080003673CT04
BLUE CROSS BLUE SHEILD
CT
Enumeration date
08/01/2006
Last updated
07/07/2014
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