Individual
BRIAN TETREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
51 APPLEGATE LN, EAST HARTFORD, CT 06118-1201
(860) 568-7520
Mailing address
44 LISKA RD, WILLINGTON, CT 06279-1411
(860) 429-2952
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000561
CT
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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