Individual
ERIC THARALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
75 GREAT POND RD, SIMSBURY, CT 06070-1980
(860) 658-3700
Mailing address
61 SIMSBURY LNDG, SIMSBURY, CT 06070-1437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006900
CT
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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