Individual
CAMERON ELISHA TABACSKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
84 GLASTONBURY BLVD STE 101, GLASTONBURY, CT 06033-4468
(860) 652-8883
Mailing address
211 POMEROY AVE APT 2301, MERIDEN, CT 06450-1770
(878) 379-6080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
14133
CT
Other
Enumeration date
08/25/2023
Last updated
08/28/2023
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