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General NPI Number Information
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NPI Number | 1316413776
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Entity Type | Organization
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Legal Business Name | KILLIANS THERAPEUTIC SERVICES LLC
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 11/27/2018
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Provider Practice Location Address
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Address Line | 10 HIGGINS HWY STE 12
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City | MANSFIELD CENTER
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State | CT
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Zip | 06250-1437
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Country | US
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Telephone | 860-456-3772
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Fax | 860-456-4941
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Provider Business Mailing Address
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Address Line | 10 HIGGINS HWY STE 12
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City | MANSFIELD CENTER
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State | CT
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Zip | 06250-1437
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Country | US
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Telephone | 860-456-3772
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Fax | 860-456-4941
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Authorized Official
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Title or Position | PT, OWNER
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Name | VERA KILLIAN
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Credential | PT
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Telephone | 860-456-3772
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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 |
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License Number State |
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