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General NPI Number Information
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NPI Number | 1689865792
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Entity Type | Organization
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Legal Business Name | THOMASTON PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 258 S MAIN ST
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City | THOMASTON
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State | CT
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Zip | 06787-1815
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Country | US
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Telephone | 860-283-2316
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Fax | 860-283-6079
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Provider Business Mailing Address
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Address Line | 258 S MAIN ST
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City | THOMASTON
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State | CT
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Zip | 06787-1815
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Country | US
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Telephone | 860-283-2316
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Fax | 860-283-6079
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/DIRECTOR
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Name | MR. DALE L SWEET JR.
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Credential | P.T.
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Telephone | 860-283-2316
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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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