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General NPI Number Information
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NPI Number | 1851359186
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY ASSOCIATES INC
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 417 HIGHLAND AVE SUITE 2
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City | WATERBURY
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State | CT
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Zip | 06708-3454
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Country | US
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Telephone | 203-573-9806
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Fax | 203-573-9806
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Provider Business Mailing Address
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Address Line | 417 HIGHLAND AVE SUITE 2
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City | WATERBURY
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State | CT
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Zip | 06708-3454
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Country | US
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Telephone | 203-573-9806
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Fax | 203-573-9806
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Authorized Official
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Title or Position | OWNER PHYSICAL THERAPIST
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Name | MRS. JOYCE L BEA
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Credential | RPT
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Telephone | 203-573-9806
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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 | 001428
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License Number State | CT
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