Individual
MRS. JODI MARAK OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5 PEQUOT PARK RD, SUITE 303, WESTBROOK, CT 06498-2856
(860) 399-6411
Mailing address
867 W POND MEADOW RD, WESTBROOK, CT 06498-2836
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000189
CT
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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