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Individual

MR. DAVID STICKNEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC, PES

Contact information

Practice address
600 MAIN ST, BRIDGEPORT, CT 06604-5105
(203) 345-4816
Mailing address
600 MAIN ST, BRIDGEPORT, CT 06604-5105
(203) 345-4816

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
000851
CT
174400000X
Specialist
RT004437
PA

Other

Enumeration date
09/23/2009
Last updated
07/31/2015
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