# SHORELINE PHYSICAL THERAPY, LLC

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

## Provider details

- **NPI number:** 1841489168
- **Authorized official:** MRS. JOANNE Z MOORE PT,DHSC,OCS (OWNER)
- **Authorized official phone:** (860) 739-4497

## Contact information

- **Practice address:** 131 BOSTON POST RD, EAST LYME, CT 06333-1605
- **Practice address phone:** (860) 739-4497
- **Practice address fax:** (860) 739-7256
- **Mailing address:** 131 BOSTON POST RD, EAST LYME, CT 06333-1605
- **Mailing address phone:** (860) 739-4497
- **Mailing address fax:** (860) 739-7256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | Yes |
| 225100000X | Physical Therapist | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 10/23/2007
- **Last updated:** 10/23/2007