Individual
GERDT PROPFE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
27 DEPOT ST, WATERTOWN, CT 06795-2601
(860) 274-4092
(860) 274-4099
Mailing address
495 GOLD STAR HWY, SUITE 112, GROTON, CT 06340-6228
(860) 446-8254
(860) 446-8293
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1847
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080001847CT02
ANTHEM BC BS
CT
Enumeration date
05/23/2007
Last updated
10/29/2007
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