Individual
REBECCA LAVAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
168 CENTER STREET, SUITE 103, SOUTHINGTON, CT 06489
(203) 268-8888
Mailing address
103 PLANK RD, PROSPECT, CT 06712
(203) 232-5924
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007929
CT
Other
Enumeration date
03/02/2009
Last updated
11/02/2017
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