GEORGIANNA FORMAN TATA

WATERBURY, CT
NPI1790796688
Former NameGEORGIANNA FORMAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CT  006595)
Enumeration Date2006-08-10
Last Update Date2007-07-08
Business Address
Mrs. GEORGIANNA FORMAN TATA PT
60 WESTWOOD AVE
WATERBURY, CT 06708-2460
Phone number: 203-597-1609
Mailing Address
Mrs. GEORGIANNA FORMAN TATA PT
219 MATTHEW ST
PROSPECT, CT 06712-1417
Phone number: 203-758-4249
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