Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3893 | CT |
N | 2251N0400X | Physical Therapist - Neurology | 3893 | CT |
N | 2251P0200X | Physical Therapist - Pediatrics | 3893 | CT |
NPI | 1679898522 |
---|---|
Provider Name | Dr. Michelle B Broggi |
First Address | Cheshire, CT 06410-2549 |
Second Address | Cheshire, CT 06410-2549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2010 |
Last Update Date | 05/04/2010 |