Mrs. Carol Davidson Fortin
Physical Therapist - Geriatrics
22 Masonic Ave
Wallingford
, Connecticut 06492-3048
Mrs. Carol Davidson Fortin
Physical Therapist - Geriatrics
22 Masonic Ave
Wallingford
, Connecticut 06492-3048
(203) 679-5959
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About
Features
Specialties
- Physical Therapist - Geriatrics
Languages spoken
- English
Location
First Address
- Mrs. Carol Davidson Fortin
- 22 Masonic Ave
- Wallingford, CT
- Zip : 06492-3048
- Phone : (203) 679-5959
Second Address
- Mrs. Carol Davidson Fortin
- 22 Masonic Ave
- Wallingford, CT
- Zip : 06492-3048
- Phone : (203) 679-5959
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251G0304X | Physical Therapist - Geriatrics | 001688 | CT |
National Provider Identifier
| NPI | 1053799205 |
|---|---|
| Provider Name | Mrs. Carol Davidson Fortin |
| First Address | Wallingford, CT 06492-3048 |
| Second Address | Wallingford, CT 06492-3048 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/05/2015 |
| Last Update Date | 08/05/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.