# WHOLEBODY WELLNESS AND PHYSICAL THERAPY

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

## Provider details

- **NPI number:** 1558776203
- **Authorized official:** CAROL M GORDON (OWNER)
- **Authorized official phone:** (860) 916-5497

## Contact information

- **Practice address:** 78 EASTERN BLVD, GLASTONBURY, CT 06033-4325
- **Practice address phone:** (860) 916-5497
- **Mailing address:** 36 FOX DEN RD, GLASTONBURY, CT 06033-4163
- **Mailing address phone:** (860) 916-5497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 002520 | CT | Yes |

## Other

- **Enumeration date:** 06/20/2014
- **Last updated:** 06/20/2014