Individual
THERESA M GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
245 ALVORD PARK, TORRINGTON, CT 06790
(860) 482-8539
(860) 482-0258
Mailing address
245 ALVORD PARK, TORRINGTON, CT 06790
(860) 482-8539
(860) 482-0258
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003889
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080003889CT22
BC
—
01
—
4220313
AETNA
CT
Enumeration date
05/24/2006
Last updated
11/30/2014
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