Organization
GOLD COAST REHABILITATION MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT R BLIZZARD III (OWNER)
(203) 517-9332
Entity
Organization
Contact information
Practice address
43 PALMER AVE APT A, STAMFORD, CT 06902-5307
(203) 517-9332
Mailing address
43 PALMER AVE APT A, STAMFORD, CT 06902-5307
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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