| Doctor Name: | MARY SUE AGOSTINI |
| NPI Number: | 1790746295 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 004064 |
| Business Practice Address: | 158 South Broad Street Dynamic Physical Therapy Llc Pawcatuck, CT - 06379 |
| Business Phone Number: | 8605990819 |
| Business Fax Number: | 8605990871 |
| Mailing Address: | 158 South Broad Street, Dynamic Physical Therapy Llc PAWCATUCK |
| State: | CT |
| Postal Code: | 06379 |
| Phone Number: | 8605990819 |
| Fax Number: | 8605990871 |
| NPI Enumeration Date: | 04/01/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 004064 |
| 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 |