Organization
HAIR STOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY BRISTOL (OWNER)
(860) 688-4590
Entity
Organization
Contact information
Practice address
41 POQUONOCK AVE, WINDSOR, CT 06095-2540
(860) 688-4590
Mailing address
41 POQUONOCK AVE, WINDSOR, CT 06095-2540
(860) 688-4590
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
020396
CT
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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