Black Rock Physical Therapy Llc

NPI 1063650901 - Clinic/Center - 261QP2000X

NPI Details
NPI 1063650901
Enumeration Date 01/30/2009
Last Updated 06/24/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name TARA LYNN TARA
Position PHYSICAL THERAPIST/OWNER
Phone (203) 335-1987
Fax (203) 549-0725
Practice Location
2889 FAIRFIELD AVE
BRIDGEPORT CT, 06605-3211, US
Phone (203) 335-1987
Fax (203) 549-0725
Business Location
2889 FAIRFIELD AVE
BRIDGEPORT CT, 06605-3211, US
Phone (203) 335-1987
Fax (203) 549-0725
Toxanomy
Taxonomy Code 261QP2000X
License State Connecticut
License Number 004078
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According to our database, Black Rock Physical Therapy Llc NPI is 1063650901, taxonomy code is 261QP2000X and license number is 004078, license state is located at Connecticut. Black Rock Physical Therapy Llc physically located at 2889 Fairfield Ave, Bridgeport CT, 06605-3211. NPI Number 1033115704 has the healthcare provider type.

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1063650901 NPI number is provided on an as is basis without warranty of any kind. 1063650901 is maintained by the National Plan & Provider Enumeration System. The contents of Black Rock Physical Therapy Llc are for informational purposes only.