| Organization Name: | FUNCTIONAL REHAB & FITNESS LLC |
| NPI Number: | 1093881559 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GAIL THERESA HENDERSON (OWNER) |
| Mailing Address: | 350 Litchfield Rd New Milford |
| State: | CT US |
| Postal Code: | 067762003 |
| Phone Number: | 8603555373 |
| Fax Number: | 8603558171 |
| NPI Enumeration Date: | 11/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 4346 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |