| NPI | 1386396299 |
|---|---|
| Former Name | TRACEY COLANTONIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic (Licence: CT 10833) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CT 10833) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-11-29 |