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Organization

HEADZONE LLC

Active
Other names
HeadZone Concussion Care
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TAMMY CARRASQUILLO (OFFICE MANAGER)
(203) 527-3181
Entity
Organization

Contact information

Practice address
1389 W MAIN ST, SUITE 325, WATERBURY, CT 06708-3104
(203) 527-3181
Mailing address
1389 W MAIN ST, SUITE 325, WATERBURY, CT 06708-3104
(203) 527-3181

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
CLPOL0098
CT
261QM2500X
Medical Specialty Clinic/Center
Primary
CLPOL0098
CT

Other

Enumeration date
08/08/2012
Last updated
08/08/2012
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