Individual
MS. MERRY ELLEN GASOREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
595 VALLEY ST, WILLIMANTIC, CT 06226-1901
(860) 450-7060
Mailing address
87 SCHOOL ST, MANCHESTER, CT 06040-6115
(860) 643-9949
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000125
CT
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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