| NPI | 1295838688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK ANTHONY WENZEL Managing Member 860-436-6772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CT 006301) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |