Individual
STACY TODISCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6448 MAIN ST, TRUMBULL, CT 06611-2075
(203) 268-6204
Mailing address
6448 MAIN ST, TRUMBULL, CT 06611-2075
(203) 268-6204
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001547
CT
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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