# MCKIERNAN PHYSICAL THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Allied Health & Wellness Centers
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841301561
- **Authorized official:** EDWARD G MCKIERNAN RPT (OWNER)
- **Authorized official phone:** (203) 268-5801

## Contact information

- **Practice address:** 115 TECHNOLOGY DR, STE A-200, TRUMBULL, CT 06611-6337
- **Practice address phone:** (203) 268-5801
- **Practice address fax:** (203) 452-3688
- **Mailing address:** 115 TECHNOLOGY DR, STE A-200, TRUMBULL, CT 06611-6337
- **Mailing address phone:** (203) 268-5801
- **Mailing address fax:** (203) 452-3688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 004917 | CT | Yes |
| 332BC3200X | Customized Equipment (DME) | 004917 | CT | — |
| 335E00000X | Prosthetic/Orthotic Supplier | 004917 | CT | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 01/30/2013