Individual
MARGARET LOUSIE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
20 RACHEL LN, IVORYTON, CT 06442-1154
(860) 391-2070
Mailing address
20 RACHEL LN, IVORYTON, CT 06442-1154
(860) 391-2070
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
004676
CT
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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