Organization
ORTHOPEDIC PHYSICAL THERAPY OF SOUTHERN NEW ENGLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN KENNETH GAMBLE MS, PT (PHYSICAL THERAPIST/OWNER)
(860) 887-6408
Entity
Organization
Contact information
Practice address
7 CLINIC DR, NORWICH, CT 06360-2915
(860) 887-6408
(860) 887-6592
Mailing address
7 CLINIC DR, NORWICH, CT 06360-2915
(860) 887-6408
(860) 887-6592
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
003827
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650001190
MEDICARE ID NUMBER
CT
01
—
C03410
MEDICARE GROUP NUMBER
CT
Enumeration date
02/12/2008
Last updated
03/12/2013
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