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Individual

LAUREN V WERKHOVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
607 BANTAM RD, UNIT H, BANTAM, CT 06750-1601
(860) 567-7787
Mailing address
73 NEWTON RD, STE 101, PLAISTOW, NH 03865-2424
(978) 388-7272
(978) 388-7373

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007202
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004237948
CT
01
080007202CT08
ANTHEM INDIV #
CT
01
650001152
MEDICARE PTAN
CT
Enumeration date
07/08/2006
Last updated
06/24/2015
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