Individual
MS. MARY I DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD,PT
Contact information
Practice address
950 CAMPBELL AVE, VA CT MAIL STOP 117, WEST HAVEN, CT 06516-2770
(203) 932-5711
(203) 937-4707
Mailing address
950 CAMPBELL AVE, VA CT MAIL STOP 117, WEST HAVEN, CT 06516-2770
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006284
CT
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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