| NPI | 1811955503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAZARUS SUREN DONABEDIAN Director Managing 860-966-7226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-08-22 |