Individual
NIKO VENANCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
187 LEDGEWOOD RD, APT 307, GROTON, CT 06340-6618
(800) 330-7711
Mailing address
187 LEDGEWOOD RD, APT 307, GROTON, CT 06340-6618
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10403
CT
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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