| NPI | 1912446840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN CHABAK Owner 860-759-4175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CT 004755) |
| Enumeration Date | 2017-02-12 |
| Last Update Date | 2017-02-12 |