Individual
SAMANTHA RAE NOVEMBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
5151 PARK AVE, FAIRFIELD, CT 06825-1090
(203) 396-8109
Mailing address
5036 MAIN ST, TRUMBULL, CT 06611-4712
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001240
CT
Other
Enumeration date
03/31/2020
Last updated
03/31/2020
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