| NPI | 1568819266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY BLAIR Owner 860-608-5019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: VA 2305207764) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2021-02-23 |