# PHYSIOCARE PHYSICAL THERAPY AND SPORTS MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PhysioCare Physical Therapy and Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598051260
- **Authorized official:** MR. JOHN H BRADFORD PT (OWNER/PHYSICAL THERAPIST)
- **Authorized official phone:** (860) 608-2773

## Contact information

- **Practice address:** 11 CENTRE ST, SUITE 6&7, SALEM, CT 06420-3844
- **Practice address phone:** (860) 608-2773
- **Practice address fax:** (860) 471-8388
- **Mailing address:** 11 CENTRE ST, SUITE 6&7, SALEM, CT 06420-3844
- **Mailing address phone:** (860) 608-2773
- **Mailing address fax:** (860) 471-8388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 006963 | CT | Yes |
| 225100000X | Physical Therapist | 009704 | CT | — |
| 225X00000X | Occupational Therapist | 004259 | CT | — |

## Other

- **Enumeration date:** 06/21/2011
- **Last updated:** 10/02/2014