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Individual

MRS. JEIMY BUENO CANOSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
3180 MAIN ST, SUITE G2, BRIDGEPORT, CT 06606-4237
(203) 520-2642
Mailing address
3180 MAIN ST, SUITE G2, BRIDGEPORT, CT 06606-4237
(203) 372-9879
(203) 373-1271

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008961
CT

Other

Enumeration date
10/17/2011
Last updated
11/04/2011
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