NPI 1396933750

Juliet Lacaran Boltz, MASSAGETHERAPIST

Practitioner Mechanotherapist Waterford, CT

Practice location

Address: 728 Broad Street Ext, Waterford, CT 06385-1345
Phone: (860) 867-6450
Fax: (860) 437-4567

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 002683 (CT)

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Registry record

NPI: 1396933750
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Oct 2007
Record last updated: 11 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.