| NPI | 1487723904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A DICHELLO Manager 860-583-6378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251H1200X Physical Therapist Hand |
| 2251S0007X Physical Therapist Sports | |
| 2251X0800X Physical Therapist Orthopedic | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |