Individual
MS. AUDREY JO TRAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2B LEE ROAD, LISBON, CT 06351
(860) 376-2564
(860) 376-4812
Mailing address
2B LEE RD, LISBON, CT 06351-3042
(860) 376-2564
(860) 376-4812
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007223
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235801
—
CT
01
—
080007223CT04
BCBS
CT
Enumeration date
08/07/2006
Last updated
04/25/2024
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