| Wellness Locker, Llc | |
|
5a Sunset Ave Putnam CT 06260-2915 | |
| (860) 481-2950 | |
| (860) 928-4079 |
| Full Name | Wellness Locker, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5a Sunset Ave, Putnam, Connecticut |
| Authorized Official Name and Position | Olivia Shea Locker (PROPRIETOR) |
| Authorized Official Contact | 8604812950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Locker, Llc 5a Sunset Ave Putnam CT 06260-2915 Ph: (860) 481-2950 | Wellness Locker, Llc 5a Sunset Ave Putnam CT 06260-2915 Ph: (860) 481-2950 |
| NPI Number | 1922479369 |
|---|---|
| Provider Enumeration Date | 10/12/2015 |
| Last Update Date | 10/21/2024 |
| Medicare PECOS PAC ID | 6305148214 |
|---|---|
| Medicare Enrollment ID | O20160111000131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922479369 | NPI | - | NPPES |
| 008062229 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 53961 (Connecticut) | Primary |
| Provider Name | Olivia S Locker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336218304 PECOS PAC ID: 4385946292 Enrollment ID: I20160111000213 |
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