Individual
TRACY M VAN VUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
80 STONINGTON RD, SUITE A3, MYSTIC, CT 06355-2965
(860) 536-1699
Mailing address
80 STONINGTON RD, SUITE A3, MYSTIC, CT 06355-2965
(860) 536-1699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7590
CT
Other
Enumeration date
04/09/2007
Last updated
01/10/2013
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