Healthcare Provider Details

I. General information

NPI: 1407903545
Provider Name (Legal Business Name): CENTER REHABILITATION & SPORTS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 COMMERCE PARK STE D
MILFORD CT
06460-3513
US

IV. Provider business mailing address

60 COMMERCE PARK STE D
MILFORD CT
06460-3513
US

V. Phone/Fax

Practice location:
  • Phone: 203-882-9384
  • Fax: 203-882-9385
Mailing address:
  • Phone: 203-882-9384
  • Fax: 203-882-9385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number4793
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number004793
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: BRIAN TIMOTHY WILLIAMS
Title or Position: OWNER
Credential: MSPT
Phone: 203-882-9384