Individual
LAUREL LOVELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
98 WASHINGTON ST, MIDDLETOWN, CT 06457-2803
(860) 462-6474
Mailing address
7 RIVERSIDE ST, PORTLAND, CT 06480-1952
(860) 834-3341
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009246
CT
Other
Enumeration date
05/10/2017
Last updated
05/10/2017
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