Provider Demographics
NPI:1528523941
Name:FRANCOEUR, CAMERON JOSEPH (LMT)
Entity type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:JOSEPH
Last Name:FRANCOEUR
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 BLACKSTONE VLG
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-2407
Mailing Address - Country:US
Mailing Address - Phone:203-600-9745
Mailing Address - Fax:
Practice Address - Street 1:363 NEW BRITAIN RD FL 2
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:CT
Practice Address - Zip Code:06037-1318
Practice Address - Country:US
Practice Address - Phone:203-600-9745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10315225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist