Individual
MR. MICHAEL RICHARD SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
61 N PLAINS INDUSTRIAL RD, WALLINGFORD, CT 06492-5841
(860) 805-7259
Mailing address
449 WALNUT TREE HILL RD, SHELTON, CT 06484-2046
(203) 395-6993
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1311
CT
Other
Enumeration date
12/30/2017
Last updated
12/30/2017
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