Individual
BRUCE MANDELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3519 POST RD, SOUTHPORT, CT 06890-1180
(203) 254-2633
Mailing address
3519 POST RD, SOUTHPORT, CT 06890-1180
(203) 254-2633
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
000122
CT
225700000X
Massage Therapist
—
—
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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