Individual
MR. KEVIN M CONNELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
97 BARNES RD, WALLINGFORD, CT 06492-1885
(203) 793-7592
(203) 793-7397
Mailing address
47 N MAIN ST, WEST HARTFORD, CT 06107-1926
(860) 409-4595
(860) 409-4860
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7235
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007235
STATE LICENSE
CT
Enumeration date
09/20/2006
Last updated
07/24/2015
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