Individual
MRS. KELLY CAPOBIANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC,CSCS
Contact information
Practice address
1013 PLAINFIELD PIKE, ONECO, CT 06373
(860) 690-6721
Mailing address
PO BOX 265, ONECO, CT 06373-0265
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
146561574
CT
Other
Enumeration date
01/23/2007
Last updated
03/25/2022
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