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NPI Code Detail

MEDICARE: SELECT PHYSICAL THERAPY

MEDICARE: SELECT PHYSICAL THERAPY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist001726CT

General Provider Information

NPI Number : 1033533898
Entity Type Code : Organization
Provider Name (Legal Business Name) : SELECT PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 510 COTTAGE GROVE RD
Second Line :
City : BLOOMFIELD
State : CT
Zip : 06002-3165
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 510 COTTAGE GROVE RD
Second Line :
City : BLOOMFIELD
State : CT
Zip : 06002-3165
Country : US
Telephone Number : 860-769-6690
Fax Number :
Authorized Official
Title or Position : CENTER MANAGER
Name : JONATHAN ECKERT
Credential :
Telephone Number : 860-769-6690
Provider Enumeration Date : 02/13/2014
Last Update Date : 02/13/2014

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Directions to “SELECT PHYSICAL THERAPY ” Practice Location

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