| NPI | 1922567544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY L WATSON Director 860-628-0823 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2020-03-05 |