Individual
MELISSA S. BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1224 MAIN ST, BRANFORD, CT 06405-3778
(203) 483-3825
Mailing address
2408 WHITNEY AVE, HAMDEN, CT 06518-3209
(203) 483-3825
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7549
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285875567
—
CT
Enumeration date
03/16/2009
Last updated
07/15/2016
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