Individual
KHALAF JERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
180 N TAYLOR AVE, NORWALK, CT 06854-1118
(203) 822-1787
Mailing address
180 N TAYLOR AVE, NORWALK, CT 06854-1118
(203) 822-1787
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009421
CT
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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