Individual
MRS. JULIET LACARAN BOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
728 BROAD STREET EXT, WATERFORD, CT 06385-1345
(860) 867-6450
(860) 437-4567
Mailing address
728 BROAD STREET EXT, WATERFORD, CT 06385-1345
(860) 867-6450
(860) 437-4567
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
002683
CT
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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