| Ct Rehabilitation & Spasticity Care, Llc | |
|
340 N Main St Southington CT 06489-2529 | |
| (860) 628-3111 | |
| Not Available |
| Full Name | Ct Rehabilitation & Spasticity Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 340 N Main St, Southington, Connecticut |
| Authorized Official Name and Position | Matthew Patrick Raymond (MANAGING MEMBER) |
| Authorized Official Contact | 8606283111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ct Rehabilitation & Spasticity Care, Llc 340 N Main St Southington CT 06489-2529 Ph: (860) 628-3111 | Ct Rehabilitation & Spasticity Care, Llc 340 N Main St Southington CT 06489-2529 Ph: (860) 628-3111 |
| NPI Number | 1629356431 |
|---|---|
| Provider Enumeration Date | 07/27/2011 |
| Last Update Date | 07/27/2011 |
| Medicare PECOS PAC ID | 6204005689 |
|---|---|
| Medicare Enrollment ID | O20110802000399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629356431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 000534 (Connecticut) | Primary |
| Provider Name | Matthew P Raymond |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457332181 PECOS PAC ID: 0244314466 Enrollment ID: I20080227000261 |
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