Individual
GLENN BREDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
850 ATLANTIC ST UNIT 301, BRIDGEPORT, CT 06604-5269
(203) 953-2722
Mailing address
850 ATLANTIC ST UNIT 301, BRIDGEPORT, CT 06604-5269
(203) 953-2722
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
001456
CT
225700000X
Massage Therapist
—
—
Other
Enumeration date
08/06/2021
Last updated
08/06/2021
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