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Individual

MRS. SUSAN FERRIER LANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19 HALLS RD, SUITE 213, OLD LYME, CT 06371-1457
(860) 434-1190
(860) 434-1190
Mailing address
PO BOX 172, OLD LYME, CT 06371-0172
(860) 434-1190
(860) 434-1190

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005063
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080005063CT05
BLUE CROSS & BLUE SHIELD
CT
Enumeration date
01/02/2007
Last updated
11/06/2009
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