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NPI Code Detail

MEDICARE: WOODBURY PHYSICAL THERAPY LLC

MEDICARE: WOODBURY PHYSICAL THERAPY LLC
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
1208100000XPhysical Medicine & Rehabilitation Physician001680CT

General Provider Information

NPI Number : 1770562720
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOODBURY PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 264 MAIN ST S
Second Line : STE 200
City : WOODBURY
State : CT
Zip : 06798
Country : US
Telephone Number : 203-263-0002
Fax Number : 203-263-0090
Provider Business Practice Location Address
First Line : 264 MAIN ST S
Second Line : STE 200
City : WOODBURY
State : CT
Zip : 06798
Country : US
Telephone Number : 203-263-0002
Fax Number : 203-263-0090
Authorized Official
Title or Position : RPT
Name : MRS. MAUREEN MUNSON BETTE
Credential :
Telephone Number : 203-263-0002
Provider Enumeration Date : 01/10/2006
Last Update Date : 10/04/2007

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Directions to “WOODBURY PHYSICAL THERAPY LLC ” Practice Location

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