Individual
DOUGLAS MICHLOVITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 CANTERBURY LN, SANDY HOOK, CT 06482-1576
(203) 364-9678
Mailing address
7 CANTERBURY LN, SANDY HOOK, CT 06482-1576
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000707
CT
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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