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General NPI Number Information
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NPI Number | 1366090870
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Entity Type | Individual
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Provider Name | CHRISTOPHER SPAGNOLETTI JR. DPT, ATC, LAT, TPI-1
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Gender | Male
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 51 SHERMAN HILL RD
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City | WOODBURY
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State | CT
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Zip | 06798-3648
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Country | US
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Telephone | 203-263-3104
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Fax | 203-263-4050
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Provider Business Mailing Address
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Address Line | 1579 STRAITS TPKE
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City | MIDDLEBURY
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State | CT
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Zip | 06762-1835
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Country | US
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Telephone | 860-274-3376
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Fax |
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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 | 12399
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License Number State | CT
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