Individual
MISS BONNIE MULLALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
(203) 365-6400
Mailing address
4200 PARK AVE, BRIDGEPORT, CT 06604-1049
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
011586
CT
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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