Healthcare Provider Details

I. General information

NPI: 1083848220
Provider Name (Legal Business Name): PERSONAL THERAPY AND HOME SAFETY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2009
Last Update Date: 05/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 COLDBROOK RD
SOUTH GLASTONBURY CT
06073-2709
US

IV. Provider business mailing address

129 COLDBROOK RD
SOUTH GLASTONBURY CT
06073-2709
US

V. Phone/Fax

Practice location:
  • Phone: 203-430-5135
  • Fax:
Mailing address:
  • Phone: 203-430-5135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number006729
License Number StateCT

VIII. Authorized Official

Name: MR. JOSHUA NOYES
Title or Position: OWNER
Credential: PT
Phone: 203-430-5135