Organization
LITTLE ANTZ LLC
Active
Other names
Infant Massage LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LETICIA S. JACQUET PT, DPT (PHYSICAL THERAPIST/OWNER)
(860) 251-9754
Entity
Organization
Contact information
Practice address
776 FARMINGTON AVE, WEST HARTFORD, CT 06119-1677
(860) 251-9754
(860) 969-0821
Mailing address
1022 BOULEVARD # 274, WEST HARTFORD, CT 06119-1801
(860) 251-9754
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043542657
—
CT
Enumeration date
01/11/2019
Last updated
09/30/2020
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