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General NPI Number Information
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NPI Number | 1063688042
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Entity Type | Organization
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Legal Business Name | INTEGRATED SPORTS THERAPY, PC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 180 POST RD E STE 209
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City | WESTPORT
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State | CT
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Zip | 06880-3414
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Country | US
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Telephone | 203-292-9353
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Fax | 203-292-9353
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Provider Business Mailing Address
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Address Line | 180 POST ROAD EAST SUITE 209
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City | WESTPORT
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State | CT
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Zip | 06880-3414
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Country | US
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Telephone | 203-292-9353
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Fax | 203-292-9532
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | DR. EDWARD J ZEBRO
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Credential | D.C.
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Telephone | 203-292-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 007391
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 001725
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License Number State | CT
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