Jenna Russell Dallinga LMT

NPI 1053687715 - Specialist - 174400000X

NPI Details
NPI 1053687715
Gender Female
Enumeration Date 03/27/2012
Last Updated 03/27/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
40 LAKE AVENUE EXT
DANBURY CT, 06811-5283, US
Phone (845) 612-9849
Fax
Business Location
103 HARVEST DR
BREWSTER NY, 10509-3706, US
Phone (845) 612-9849
Fax
Toxanomy
Taxonomy Code 174400000X
License State Connecticut
License Number 005456
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According to our database, Ms. Jenna Russell Dallinga LMT NPI is 1053687715, taxonomy code is 174400000X and license number is 005456, license state is located at Connecticut. Jenna Russell Dallinga LMT physically located at 40 Lake Avenue Ext, Danbury CT, 06811-5283. NPI Number Jenna Russell Dallinga LMT has the Individual type.

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1053687715 NPI number is provided on an as is basis without warranty of any kind. 1053687715 is maintained by the National Plan & Provider Enumeration System. The contents of Jenna Russell Dallinga LMT are for informational purposes only.