| NPI | 1790276368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANNA HEANEY Member 860-758-0754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CT 006733) |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2018-05-19 |