Healthcare Provider Details

I. General information

NPI: 1063780112
Provider Name (Legal Business Name): BEST HEALTH PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 LONG HILL RD STE 101
GROTON CT
06340
US

IV. Provider business mailing address

PO BOX 302
GROTON CT
06340-0302
US

V. Phone/Fax

Practice location:
  • Phone: 860-326-5454
  • Fax: 860-326-5502
Mailing address:
  • Phone: 860-326-5454
  • Fax: 888-371-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRAVIS LOMBARDI
Title or Position: OWNER
Credential: PT, MSPT
Phone: 860-326-5454