Individual
ANGELA MOYLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3396 E MAIN ST, WATERBURY, CT 06705-3812
(203) 754-2161
(203) 759-7359
Mailing address
3396 E MAIN ST, WATERBURY, CT 06705-3812
(203) 754-2161
(203) 759-7359
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007374
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11758617
CAQH
CT
Enumeration date
01/12/2007
Last updated
01/23/2014
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