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General NPI Number Information
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NPI Number | 1649925173
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Entity Type | Organization
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Legal Business Name | RESILIENT PERFORMANCE PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 315 MIDDLESEX RD
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City | DARIEN
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State | CT
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Zip | 06820-4316
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Country | US
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Telephone | 929-429-5086
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Fax |
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Provider Business Mailing Address
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Address Line | 148 COLLEGE PL
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-2506
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Country | US
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Telephone | 309-824-5130
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | TREVOR RAPPA
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Credential |
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Telephone | 309-824-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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