Individual
JENNIFER BARSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
401 MONROE TPKE, VILLAGE SQUARE MEDICAL OFFICES, MONROE, CT 06468-2276
(203) 445-8691
(203) 445-8692
Mailing address
31 OLD ROUTE 7, ATTN: CREDENTIALING DEPT, BROOKFIELD, CT 06804-1714
(203) 740-0020
(203) 775-0238
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005889
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114979226
CARLSON THERAPY GROUP NPI#
CT
Enumeration date
07/27/2006
Last updated
05/29/2008
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