Individual
STEVEN BANDTLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
270 MOHEGAN AVE, NEW LONDON, CT 06320-4125
(806) 439-2086
Mailing address
955 GLASTONBURY TPKE, PORTLAND, CT 06480-1029
(860) 550-2924
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000813
CT
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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