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Organization
PHYSIOCARE PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Active
Organization
PHYSIOCARE PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Active
Parent organization
PHYSIOCARE PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSIOCARE PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Authorized official
JOHN HOWARD BRADFORD DPT (OWNER)
(860) 949-2561
Entity
Organization
Contact information
Practice address
131 BOSTON POST RD, EAST LYME, CT 06333-1605
(860) 949-2561
Mailing address
11 CENTRE ST STE 7, SALEM, CT 06420-3845
(860) 949-2561
(860) 471-8388
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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