Individual
JACQUELINE MARIE CARRERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10 LOEFFLER RD, BLOOMFIELD, CT 06002-2256
(860) 729-2413
Mailing address
PO BOX 593, WINDSOR LOCKS, CT 06096-0593
(508) 615-1113
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002058
CT
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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