Jake Lange, PTA
Physical Therapy Assistant in Branford, CT. Individual provider (NPI-1).
NPI number1194350090
StatusActive
Last updated in NPPESMar 11, 2020
Details
- NPI
- 1194350090
- Entity type
- Individual (NPI-1)
- Name
- Jake Lange
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 11, 2020
- Certification date
- Mar 11, 2020
- Last updated
- Mar 11, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 002006 | CT | Yes |
Practice location
189 Alps RdBranford, CT 06405-4771
Phone 203-315-2615
Mailing address
189 Alps RdBranford, CT 06405-4771
Phone 203-315-2615
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Other Physical Therapy Assistant providers in Branford, CT
- Edgar Almanzar, PTANPI 1316360597
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- Candida Lionetti, PTANPI 1558411173
- Tiffanie NguyenNPI 1588277453
- Maria RichardsNPI 1427328806
All 7 Physical Therapy Assistant providers in Branford · All 886 providers in Branford
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