Individual
CAROL MIERZWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
115 SPENCER ST, WINSTED, CT 06098-1140
(860) 738-5810
(860) 738-5820
Mailing address
115 SPENCER ST, WINSTED, CT 06098-1140
(860) 738-5810
(860) 738-5820
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004842
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076572
MEDICARE GROUP ID
CT
Enumeration date
02/27/2009
Last updated
11/21/2013
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