Individual
RUSSELL WOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
544 CAMPBELL AVE, WEST HAVEN, CT 06516-4401
(203) 937-6150
(203) 937-8517
Mailing address
3 TAMARAC SWAMP RD, WALLINGFORD, CT 06492-5529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001241
CT
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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