Organization
ADVANCED THERAPY AND PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA KEN HEENAN I.M.D (PRESIDENT)
(203) 614-9635
Entity
Organization
Contact information
Practice address
75 SELLECK STREET, STAMFORD, CT 06902
(203) 614-9635
Mailing address
75 SELLECK STREET, STAMFORD, CT 06902
(203) 614-9635
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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