# SUBURBAN PHYSICAL THERAPY & SPORTS MEDICINE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUBURBAN PHYSICAL THERAPY & SPORTS MEDICINE CENTER, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023011681
- **Authorized official:** MR. THOMAS MICHAEL SWEENEY RPT (MEMBER DIRECTOR OF PT)
- **Authorized official phone:** (860) 721-9801

## Contact information

- **Practice address:** 506 CROMWELL AVE, STE 103, ROCKY HILL, CT 06067-1851
- **Practice address phone:** (860) 721-9801
- **Practice address fax:** (860) 721-8475
- **Mailing address:** 506 CROMWELL AVE, STE 103, ROCKY HILL, CT 06067-1851
- **Mailing address phone:** (860) 721-9801
- **Mailing address fax:** (860) 721-8475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 2251G0304X | Geriatric Physical Therapist | — | NULL | — |
| 2251G0304X | Geriatric Physical Therapist | — | — | — |
| 2251N0400X | Neurology Physical Therapist | — | NULL | — |
| 2251N0400X | Neurology Physical Therapist | — | — | — |
| 2251S0007X | Sports Physical Therapist | — | NULL | — |
| 2251S0007X | Sports Physical Therapist | — | — | — |
| 2251X0800X | Orthopedic Physical Therapist | — | NULL | — |
| 2251X0800X | Orthopedic Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 05/27/2005
- **Last updated:** 06/20/2018