Individual
MR. MICHAEL ANDREW DANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1579 STRAITS TPKE, MIDDLEBURY, CT 06762-1835
(203) 577-2002
(203) 577-2060
Mailing address
1579 STRAITS TPKE, MIDDLEBURY, CT 06762-1835
(203) 577-2002
(203) 577-2060
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006422
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004207389
—
CT
01
—
080006422CT07
ANTHEM BLUE CROSS SHIELD
CT
01
—
650016540
RAILROAD MEDICARE
CT
Enumeration date
07/07/2005
Last updated
11/03/2008
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