Organization Name: | CONNECTICUT PHYSICAL THERAPY SPECIALISTS LLC |
NPI Number: | 1639441439 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID J BOSTIC (PHYSICAL THERAPIST/OWNER) |
Mailing Address: | 9 Mill Pond Rd Suite 3 Granby |
State: | CT US |
Postal Code: | 060352628 |
Phone Number: | 8604139969 |
Fax Number: | |
NPI Enumeration Date: | 02/08/2012 |
NPI Last Update Date: | 02/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 003110 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |