TRACY E WALL
Physical Therapist


Address: 407 Madison Rd # R, Durham, CT 06422-3217

TRACY E WALL (Credential# 690602) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.

Business Overview

TRACY E WALL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.005021. The credential type is physical therapist. The effective date is October 1, 2019. The expiration date is September 30, 2020. The business address is 407 Madison Rd # R, Durham, CT 06422-3217. The current status is active.

Basic Information

Licensee Name TRACY E WALL
Credential ID 690602
Credential Number 14.005021
Credential Type Physical Therapist
Business Address 407 Madison Rd # R
Durham
CT 06422-3217
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 1994-08-19
Effective Date 2019-10-01
Expiration Date 2020-09-30
Refresh Date 2019-09-04

Office Location

Street Address 407 MADISON RD # R
City DURHAM
State CT
Zip Code 06422-3217

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Lynda S Collins · Robison 649 Wallingford Road, Durham, CT 06422 Registered Nurse 2020-07-01 ~ 2021-06-30
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Competitor

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City DURHAM
Zip Code 06422
License Type Physical Therapist
License Type + County Physical Therapist + DURHAM

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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