# CT SCOLIOSIS AND SPINE REHAB, LLC

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

## Provider details

- **NPI number:** 1801345699
- **Authorized official:** GAIL FENNELL P.T. (PHYSICAL THERAPIST/OWNER)
- **Authorized official phone:** (203) 431-0348

## Contact information

- **Practice address:** 871 ETHAN ALLEN HWY, STE 104, RIDGEFIELD, CT 06877-2800
- **Practice address phone:** (203) 431-0348
- **Practice address fax:** (203) 431-0351
- **Mailing address:** 871 ETHAN ALLEN HWY, STE. 104, RIDGEFIELD, CT 06877
- **Mailing address phone:** (203) 431-0348
- **Mailing address fax:** (203) 431-0351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 004216 | CT | Yes |

## Other

- **Enumeration date:** 09/22/2016
- **Last updated:** 09/22/2016