| NPI | 1225302136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY F REARDON Physician 860-347-7636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2012-02-24 |