Individual
LUCAS MOGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1171 E PUTNAM AVE BLDG 22ND, RIVERSIDE, CT 06878-1426
(203) 637-1700
Mailing address
1171 E PUTNAM AVE BLDG 22ND, RIVERSIDE, CT 06878-1426
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/08/2017
Last updated
06/08/2017
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