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General NPI Number Information
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NPI Number | 1770601320
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Entity Type | Individual
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Provider Name | DENNIS CHRISTOPHER RICHETELLI ATC
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 24 DANBURY RD
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City | WILTON
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State | CT
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Zip | 06897-4424
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Country | US
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Telephone | 203-563-0610
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Fax |
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Provider Business Mailing Address
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Address Line | 52 HOUSATONIC AVE
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City | MILFORD
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State | CT
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Zip | 06460-3416
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Country | US
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Telephone | 203-878-5336
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000360
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License Number State | CT
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