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Individual

KATIE RUTH BRYANT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
44 CLARK ST, 3RD FLR, ANSONIA, CT 06401-1502
(203) 732-3980
Mailing address
44 CLARK ST, 3RD FLR, ANSONIA, CT 06401
(203) 732-3980

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CODE 22
ATHLETIC TRAINER
CT
Enumeration date
04/26/2006
Last updated
07/08/2007
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