Individual
KIRSTEN LARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
24 PUTNAM PIKE, UNIT 3, DAYVILLE, CT 06241-1608
(860) 412-9016
Mailing address
24 PUTNAM PIKE, UNIT 3, DAYVILLE, CT 06241-1608
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8537
CT
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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