# FORMULA FOR PERFORMANCE & REHAB, LLC

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

## Provider details

- **NPI number:** 1992114508
- **Authorized official:** NICHOLAS CORWIN (MANAGING DIRECTOR)
- **Authorized official phone:** (203) 247-2270

## Contact information

- **Practice address:** 59 VALLEY FORGE RD, WESTON, CT 06883-1912
- **Practice address phone:** (203) 227-6666
- **Mailing address:** 59 VALLEY FORGE RD, WESTON, CT 06883-1912
- **Mailing address phone:** (203) 227-6666

## Taxonomy

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

## Other

- **Enumeration date:** 08/07/2014
- **Last updated:** 08/29/2014