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Individual

MRS. LORRAINE M DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
2 TRAP FALLS RD STE 404, SHELTON, CT 06484-7622
(203) 734-7900
(203) 513-3269
Mailing address
2 TRAP FALLS RD STE 404, SHELTON, CT 06484-7622
(203) 734-7900
(203) 513-3269

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
002268
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080002268CT02
BLUE CROSS PROVIDER #
CT
Enumeration date
10/17/2006
Last updated
01/15/2019
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