Individual
MR. DAVID J. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
35 LAKEVIEW AVE, NEW BRITAIN, CT 06052-1921
(860) 225-5419
Mailing address
35 LAKEVIEW AVE, NEW BRITAIN, CT 06052-1921
(860) 225-5419
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000062
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
ATHLETIC TRAINER
CT
Enumeration date
02/26/2007
Last updated
07/08/2007
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