Individual
GRETCHEN BROUGHTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008267
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11832080
CAQH
CT
01
—
2V5480
HEALTHNET
CT
Enumeration date
10/26/2006
Last updated
07/02/2008
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