# AMITY PHYSICAL THERAPY LLC

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

## Provider details

- **NPI number:** 1528191426
- **Authorized official:** MICHAEL F DOW MSPT (DIRECTOR PHYSICAL THERAPIST)
- **Authorized official phone:** (203) 389-4593

## Contact information

- **Practice address:** 1 BRADLEY RD, SUITE \#801, WOODBRIDGE, CT 06525-2285
- **Practice address phone:** (203) 389-4593
- **Practice address fax:** (203) 389-4609
- **Mailing address:** 1 BRADLEY RD, SUITE \#801, WOODBRIDGE, CT 06525-2285
- **Mailing address phone:** (203) 389-4593
- **Mailing address fax:** (203) 389-4609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | CT006646 | CT | Yes |
| 225100000X | Physical Therapist | CT008058 | CT | — |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 11/02/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 080006646CT07 | BCBS | CT |
| 01 | — | 20910 | ORTHONET | CT |