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Individual

GABRIELLE GITHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
607 BANTAM RD, BANTAM, CT 06750-1634
(860) 567-7787
(860) 567-7779
Mailing address
73 NEWTON RD, STE 101, PLAISTOW, NH 03865-2424
(978) 388-7272
(978) 388-7373

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9286
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D400077127
MEDICARE PTAN
CT
Enumeration date
03/31/2012
Last updated
06/24/2015
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