Individual
KYLE S ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
119 SAGAMORE RD, MERIDEN, CT 06450-2544
(203) 238-7981
Mailing address
119 SAGAMORE RD, MERIDEN, CT 06450-2544
(203) 238-7981
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000098
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000098
STATE LICENSE
CT
Enumeration date
04/26/2007
Last updated
07/08/2007
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