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Individual

MARY LATHROP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, CSCS

Contact information

Practice address
15 MOHEGAN AVE, MICHEL HALL, NEW LONDON, CT 06320-8100
(860) 444-8414
Mailing address
142 FOGARTY AVE, GRISWOLD, CT 06351-1725

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000473
CT

Other

Enumeration date
05/16/2008
Last updated
05/16/2008
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