MARY JACQUELINE BANNING

FOX REHAB PT CT, LLC

Dr MARY JACQUELINE BANNING is a female medical professional, specializing in Physical Therapy. She graduated in 2012.

Contact

FOX REHAB PT CT, LLC

655 MAIN ST S
SOUTHBURY
CT
064884220

Tel: 8774073422

MARY JACQUELINE BANNING Information

Npi 1386115681
Pac Id 4284979873
Professional Enrollment Id I20190102000231
Last Name BANNING
First Name MARY
Middle Name JACQUELINE
Suffix
Gender F
Credential
Medical School Name OTHER
Graduation Year 2012
Primary Specialty PHYSICAL THERAPY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name FOX REHAB PT CT, LLC
Group Practice Pac Id 8820235575
Number Of Group Practice Members 42
Line 1 Street Address 655 MAIN ST S
Line 2 Street Address
Marker Of Address Line 2 Suppression
City SOUTHBURY
State CT
Zip Code 064884220
Phone Number 8774073422
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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