Individual
VAISHWAN DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 22ND ST NW, WASHINGTON, DC 20052-0055
(860) 899-4756
Mailing address
130 DAVENPORT RD, WEST HARTFORD, CT 06110-2128
(860) 899-4756
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000031799
CT
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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