Individual
MS. KATHLEEN SUSAN FORTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 EMERSON DR, WINDSOR, CT 06095-3204
(860) 640-6338
Mailing address
2 HEMLOCK CIR, STAFFORD SPRINGS, CT 06076-4328
(860) 640-6338
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000997
CT
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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