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1881100634
MICHAEL VICTOR DIAS
TRUMBULL, CT
NPI
1881100634
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: CT 001008)
Enumeration Date
2017-12-15
Last Update Date
2017-12-15
Business Address
Mr. MICHAEL VICTOR DIAS ATC/ LAT
888 WHITE PLAINS RD
TRUMBULL, CT 06611-4552
Phone number: 203-459-1133
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Mailing Address
Mr. MICHAEL VICTOR DIAS ATC/ LAT
479 WOODSIDE AVE
BRIDGEPORT, CT 06606-2245
Phone number: 914-417-1864
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