Individual
ALEXANDER IMHOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC, PES
Contact information
Practice address
800 COUNTRY CLUB RD, WATERBURY, CT 06708-3240
(203) 591-5231
Mailing address
28 ARMSTRONG RD UNIT B9, COVENTRY, CT 06238-3366
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001175
CT
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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