Organization
MYSTIC HEALTHCARE AND REHABILITATION FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN ELIZABETH DORMAN RPT (REGISTERED PHYSICAL THERAPIST)
(860) 536-6070
Entity
Organization
Contact information
Practice address
475 HIGH ST, MYSTIC, CT 06355-1707
(860) 536-6070
Mailing address
475 HIGH ST, MYSTIC, CT 06355-1707
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
003480
CT
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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