Individual
MR. MICHAEL VICTOR DIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/ LAT
Contact information
Practice address
888 WHITE PLAINS RD, TRUMBULL, CT 06611-4552
(203) 459-1133
Mailing address
479 WOODSIDE AVE, BRIDGEPORT, CT 06606-2245
(914) 417-1864
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001008
CT
Other
Enumeration date
12/15/2017
Last updated
12/15/2017
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