Individual
MARY FRANGUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6723
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D100263001
MEDICARE GROUP PTAN
CT
Enumeration date
10/18/2016
Last updated
10/18/2016
Update your record
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