Individual
KELLY CORSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
642 BLACK ROCK AVE, NEW BRITAIN, CT 06052-1037
(860) 224-6010
Mailing address
59 THORPE AVE, WALLINGFORD, CT 06492-1914
(203) 627-8263
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000690
CT
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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