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General NPI Number Information
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NPI Number | 1710218607
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Entity Type | Organization
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Legal Business Name | TOTAL LEARNING AND THERAPY CENTER
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Dates
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Enumeration Date | 01/17/2010
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Last Update Date | 01/17/2010
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Provider Practice Location Address
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Address Line | 94 WEDGEWOOD DR
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City | MANCHESTER
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State | CT
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Zip | 06042-2735
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Country | US
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Telephone | 860-647-8852
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Fax |
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Provider Business Mailing Address
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Address Line | 5893 MAIN ST
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City | TRUMBULL
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State | CT
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Zip | 06611-2448
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Country | US
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Telephone | 203-268-8852
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. RANDY SCHULMAN
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Credential | OD
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Telephone | 203-268-8852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 2299
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License Number State | CT
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