Organization
SUPREME PHYSICAL THERAPY AND WELLNESS REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILICIA MATHIS DPT (CO- OWNER)
(475) 328-0009
Entity
Organization
Contact information
Practice address
1825 BARNUM AVE STE 304, STRATFORD, CT 06614-5333
(475) 328-0009
(203) 212-8528
Mailing address
14 LAYDON AVE, NORTH HAVEN, CT 06473-2704
(203) 584-3748
(203) 212-8528
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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