Individual
PAUL K. CANAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
14 DOG LN, STORRS MANSFIELD, CT 06269-9033
(860) 486-8615
Mailing address
82 KIDDER BROOK RD, ASHFORD, CT 06278-1014
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4532
CT
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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