Individual
DOROTA BOLTRUCZUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOROTA BOLTRUCZUK
Contact information
Practice address
125 OAKLAWN AVE, STAMFORD, CT 06905
(203) 921-8559
Mailing address
125 OAKLAWN AVE, STAMFORD, CT 06905
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001194
CT
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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