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Individual

BIANCA BOLDUC

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17 COMMONS DR, UNIT 6, LITCHFIELD, CT 06759
(203) 417-5864
Mailing address
43 MAPLE VIEW TRL, LITCHFIELD, CT 06759-2125
(203) 417-5864

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11191
CT
225100000X
Physical Therapist
293176
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004190328
CT
Enumeration date
11/08/2016
Last updated
07/09/2025
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