Individual
MR. RICHARD E. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
31 OLD ROUTE 7, BROOKFIELD, CT 06804-1714
(203) 740-0020
(203) 740-7354
Mailing address
31 OLD ROUTE 7, BROOKFIELD, CT 06804-1714
(203) 740-0020
(203) 775-0238
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001940
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004210126
—
CT
01
—
080001940CT
ANTHEM BC
CT
01
—
2V8093
HEALTHNET
CT
Enumeration date
06/15/2006
Last updated
07/11/2008
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