Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 005306 | CT |
NPI | 1063476273 |
---|---|
Provider Name | Mr. Matthew J Dumas |
First Address | Brooklyn, CT 06234-1830 |
Second Address | Putnam, CT 06260-1939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 08/07/2007 |