# PRYME PHYSICAL THERAPY & SPORTS MEDICINE LLC

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

## Provider details

- **NPI number:** 1285345637
- **Authorized official:** MICHAEL JOHNSON DPT (OWNER)
- **Authorized official phone:** (860) 422-0878

## Contact information

- **Practice address:** 12 OCEAN AVE, WEST HAVEN, CT 06516-7048
- **Practice address phone:** (203) 561-7714
- **Mailing address:** PO BOX 16573, WEST HAVEN, CT 06516-0983
- **Mailing address phone:** (860) 422-0878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2022
- **Last updated:** 03/23/2023