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General NPI Number Information
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NPI Number | 1841684834
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Entity Type | Organization
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Legal Business Name | CHARTER OAK HEALTH CENTER
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 21 GRAND ST
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City | HARTFORD
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State | CT
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Zip | 06106-1541
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Country | US
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Telephone | 860-550-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 21 GRAND ST
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City | HARTFORD
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State | CT
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Zip | 06106-1541
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Country | US
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Telephone | 860-550-7500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NICHELLE MULLINS
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Credential |
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Telephone | 860-550-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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