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General NPI Number Information
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NPI Number | 1134524333
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND PHYSICAL THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 1003 WALLINGFORD RD B
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City | CHESHIRE
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State | CT
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Zip | 06410-2946
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Country | US
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Telephone | 203-909-1974
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Fax |
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Provider Business Mailing Address
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Address Line | 1003 WALLINGFORD RD B
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City | CHESHIRE
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State | CT
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Zip | 06410-2946
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Country | US
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Telephone | 203-909-1974
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Fax |
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Authorized Official
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Title or Position | OWNER / PHYSICAL THERAPIST
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Name | MICHAEL E SUOMALA
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Credential | M.S.P.T.
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Telephone | 203-909-1974
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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 | 006158
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License Number State | CT
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