Individual
MR. MICHAEL KRUGLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 TOMPKINS ST, WATERBURY, CT 06708-1458
(203) 419-0381
(203) 419-0389
Mailing address
22 TOMPKINS ST, WATERBURY, CT 06708-1458
(203) 419-0381
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000291
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004190328
—
CT
Enumeration date
08/05/2009
Last updated
08/05/2009
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