Individual
KELLEN FOGANHOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
44 OLD RIDGEFIELD RD STE 213, WILTON, CT 06897-3014
(877) 407-3422
Mailing address
44 OLD RIDGEFIELD RD STE 213, WILTON, CT 06897-3014
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10070
CT
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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