Individual
MARY E. O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
130B GROVE ST, NEW MILFORD, CT 06776-3668
(860) 354-7605
(860) 355-0089
Mailing address
31 OLD ROUTE 7, BROOKFIELD, CT 06804-1714
(203) 740-0020
(203) 775-0238
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003738
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004252904
—
CT
01
—
080003738
ANTHEM BC
CT
Enumeration date
05/27/2006
Last updated
10/07/2008
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