Individual
VICTORIA THAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 N MAIN ST, MANCHESTER, CT 06042-2086
(860) 528-1359
Mailing address
94 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3013
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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