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General NPI Number Information
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NPI Number | 1265568281
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 37 SOUNDVIEW RD SUITE 2
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City | GUILFORD
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State | CT
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Zip | 06437-2916
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Country | US
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Telephone | 203-453-4321
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Fax | 203-453-4322
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Provider Business Mailing Address
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Address Line | 37 SOUNDVIEW RD SUITE 2
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City | GUILFORD
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State | CT
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Zip | 06437-2916
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Country | US
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Telephone | 203-453-4321
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Fax | 203-453-4322
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DONNA LYNN SEGNERE
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Credential | PT
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Telephone | 203-453-4321
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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 | 005209
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License Number State | CT
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