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Individual

MR. PETER SCOTT OLMSTEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, PTA

Contact information

Practice address
635 BROAD ST, NEW LONDON, CT 06320-2543
(860) 447-8558
(860) 447-4552
Mailing address
635 BROAD ST, NEW LONDON, CT 06320-2543
(860) 447-8558
(860) 447-4552

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000972
CT
2255A2300X
Athletic Trainer
000190
CT

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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