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NPI 1326423054

NPI 1326423054 : RACHEL COFFMAN : WATERBURY, CT

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General NPI Number Information
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    NPI Number           |    1326423054
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL COFFMAN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/23/2015
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    Last Update Date     |    11/09/2020
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Provider Practice Location Address
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    Address Line         |    22 TOMPKINS ST 
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    City                 |    WATERBURY
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    State                |    CT
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    Zip                  |    06708-1458
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    Country              |    US
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    Telephone            |    203-419-0381
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    Fax                  |    203-419-0389
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Provider Business Mailing Address
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    Address Line         |    1625 STRAITS TURNPIKE SUITE 300
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    City                 |    MIDDLEBURY
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    State                |    CT
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    Zip                  |    06762-1805
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    Country              |    US
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    Telephone            |    203-598-6066
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    Fax                  |    203-598-3300
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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       |    10213
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    License Number State |    CT
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