| NPI | 1194282004 |
|---|---|
| Doing Business As | PERFORMANCE PHYSICAL THERAPY AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | SIMONE BURKE Billing Manager 203-553-7626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-03-08 |