| NPI | 1760657712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANAEL T. TRYTHALL Practice Administrator 860-496-4160 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2017-10-18 |