| NPI | 1023668480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DISHON Owner/ Physical Therapist 203-260-2091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-09-18 |