Individual
MARITZA LASSALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
581 POQUONOCK AVE, WINDSOR, CT 06095-2202
(860) 688-7211
Mailing address
581 POQUONOCK AVE, WINDSOR, CT 06095-2202
(860) 688-7211
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000863
CT
225200000X
Physical Therapy Assistant
8020
MA
Other
Enumeration date
06/01/2008
Last updated
06/01/2008
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