Individual
RICARDO WIJNDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
14 CHARTER OAK PL, HARTFORD, CT 06106-1961
(860) 748-7586
Mailing address
14 CHARTER OAK PL, HARTFORD, CT 06106-1961
(860) 748-7586
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005645
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005645
LICENSE
CT
Enumeration date
02/23/2015
Last updated
02/23/2015
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