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MR. GLENN EDWARD LAVALLEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
2 GRANDVIEW LN, NEW MILFORD, CT 06776-2344
(860) 355-5101
Mailing address
2 GRANDVIEW LN, NEW MILFORD, CT 06776-2344
(860) 355-5101

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
026269-1
NY

Other

Enumeration date
11/05/2008
Last updated
05/28/2010
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