Individual
ANNAMMA PALACKAMANNIL MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
655 MAIN ST S, SOUTHBURY, CT 06488-4220
(877) 407-3422
(877) 407-4329
Mailing address
12451 NW 15TH PL APT 17306, SUNRISE, FL 33323-5246
(954) 864-2063
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11347
CT
Other
Enumeration date
08/30/2019
Last updated
04/29/2025
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