Jason Donald Rancourt
Physical Therapy Assistant in New Haven, CT. Individual provider (NPI-1).
NPI number1467117473
StatusActive
Last updated in NPPESNov 4, 2021
Details
- NPI
- 1467117473
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jason Donald Rancourt
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 4, 2021
- Certification date
- Nov 4, 2021
- Last updated
- Nov 4, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 2025 | CT | Yes |
Practice location
1450 Chapel StNew Haven, CT 06511-4405
Phone 203-789-3000
Mailing address
5 Bunting RdSeymour, CT 06483-3807
Phone 617-417-3209
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