Joint Pain Treatment Center, LLC
Nurse Practitioner in Waterbury, CT. Organization (NPI-2).
NPI number1760172001
StatusActive
Last updated in NPPESJan 18, 2024
Details
- NPI
- 1760172001
- Entity type
- Organization (NPI-2)
- Legal business name
- Joint Pain Treatment Center, LLC
- Organization subpart
- No
- Enumeration date
- May 10, 2023
- Certification date
- Jan 18, 2024
- Last updated
- Jan 18, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – |
Practice location
417 Highland AveWaterbury, CT 06708-3454
Phone 203-504-7518
Mailing address
417 Highland AveWaterbury, CT 06708-3454
Phone 203-504-7518
Other practice locations
10 Progress Dr Ste 2f
Shelton, CT 06484-6294
Shelton, CT 06484-6294
Phone 203-504-7518
Authorized official
Kristen Donohue
Owner, NP Director
2038956572
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