| NPI | 1134491574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN FRISBIE Credentialing 860-696-2502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |