Individual
SUSAN FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1 EMILY WAY, WEST HARTFORD, CT 06107-3136
(860) 561-7022
Mailing address
1 EMILY WAY, WEST HARTFORD, CT 06107-3136
(860) 561-7022
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005279
CT
Other
Enumeration date
01/26/2006
Last updated
09/19/2016
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