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General NPI Number Information
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NPI Number | 1194770040
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Entity Type | Organization
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Legal Business Name | PHYSICIANS HEALTH & WELLNESS CENTER, P.C.
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 778 NEW HAVEN RD
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City | NAUGATUCK
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State | CT
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Zip | 06770-4782
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Country | US
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Telephone | 203-723-4032
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Fax | 203-723-4753
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Provider Business Mailing Address
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Address Line | PO BOX 617
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City | NAUGATUCK
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State | CT
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Zip | 06770-0617
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Country | US
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Telephone | 203-723-4032
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Fax | 203-723-4753
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Authorized Official
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Title or Position | SENIOR MANAGER
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Name | SCOTT A HODES
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Credential | D C
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Telephone | 203-723-4032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | CT
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