Individual
MS. LISA PACIFICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
44 MARITIME DIVE, MYSTIC, CT 06355
(860) 572-1700
Mailing address
44 MARITIME DRIVE, MYSTIC, CT 06355
(860) 572-1700
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
007696
CT
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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