| Outpatient Mobile | |
|
113 Labby Rd, North Grosvenordale, CT 06255-1247 | |
| (607) 643-2178 | |
| Not Available |
| Full Name | Outpatient Mobile |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 113 Labby Rd, North Grosvenordale, Connecticut |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144793316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Outpatient Mobile 113 Labby Rd, North Grosvenordale, CT 06255-1247 Ph: (607) 643-2178 | Outpatient Mobile 113 Labby Rd, North Grosvenordale, CT 06255-1247 Ph: (607) 643-2178 |
Dr. Tanya Lee Clark, OTD, OTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 113 Labby Rd, North Grosvenordale, CT 06255 Phone: 860-497-0239 Fax: 860-497-0047 | |
Jason Ratto, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 113 Labby Rd, North Grosvenordale, CT 06255 Phone: 860-497-0239 Fax: 860-497-0047 |