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General NPI Number Information
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NPI Number | 1306207543
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Entity Type | Individual
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Provider Name | CAITLIN ROSE DEGRAY D.P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 499 FARMINGTON AVE. SUITE 300
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City | FARMINGTON
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State | CT
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Zip | 06032
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Country | US
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Telephone | 860-549-8986
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Fax | 860-284-9630
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Provider Business Mailing Address
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Address Line | 499 FARMINGTON AVE. SUITE 300
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City | FARMINGTON
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State | CT
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Zip | 06032
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Country | US
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Telephone | 860-549-8986
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Fax | 860-284-9630
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 010807
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License Number State | CT
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