Doctor Name: | MS. BETHANY G. PETRELLA |
NPI Number: | 1629132337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. , M.S.P.T. |
License Number: | 004177 |
Business Practice Address: | 333 Pomfret St Putnam, CT - 062601852 |
Business Phone Number: | 8609289444 |
Business Fax Number: | 8609284811 |
Mailing Address: | 76 Tinkerville Rd, WILLINGTON |
State: | CT |
Postal Code: | 062791426 |
Phone Number: | 8604290403 |
Fax Number: | |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 004177 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |