AMY PROVENCAL

WEST HAVEN, CT
NPI1255584561
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: CT  000199)
Enumeration Date2008-10-30
Last Update Date2008-10-30
Business Address
Mrs. AMY PROVENCAL PTA
950 CAMPBELL AVE
WEST HAVEN, CT 06516-2770
Phone number: 203-935-5711
Mailing Address
Mrs. AMY PROVENCAL PTA
139 CHARTER OAK AVE
EAST HAVEN, CT 06512-2704
Phone number: 203-467-1974
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