| NPI | 1770507345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA K JORDAN Credentialing 203-797-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 225100000X Physical Therapist |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-03-11 |