Individual
JENNIFER JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
668 BANK ST, NEW LONDON, CT 06320-5040
(860) 442-4600
Mailing address
22 PERRY AVE, WATERFORD, CT 06385-3435
(860) 437-7465
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000417
LICENSE
CT
Enumeration date
08/30/2006
Last updated
07/08/2007
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