# ESSENTIAL PHYSICAL THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053618728
- **Authorized official:** MRS. STEPHANIE A. BOLOGA M.S.,P.T. (PRINCIPAL)
- **Authorized official phone:** (860) 966-2152

## Contact information

- **Practice address:** 995 HOPMEADOW ST, SIMSBURY, CT 06070-1812
- **Practice address phone:** (860) 966-2152
- **Practice address fax:** (860) 735-6545
- **Mailing address:** 7 ANJA DR, SIMSBURY, CT 06070-1546
- **Mailing address phone:** (860) 966-2152
- **Mailing address fax:** (860) 735-6545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251S0007X | Sports Physical Therapist | — | NULL | Yes |
| 2251S0007X | Sports Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/16/2011
- **Last updated:** 02/16/2011