Organization
PERFORMANCE EDGE SPORTS, LLC
Active
Other names
Family Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J TODT MSPT, CSCS (OWNER)
(860) 917-6536
Entity
Organization
Contact information
Practice address
7 PARK AVE, SUITE 4, COLCHESTER, CT 06415-1128
(860) 531-3222
(860) 531-3224
Mailing address
7 PARK AVE, SUITE 4, COLCHESTER, CT 06415-1128
(860) 531-3222
(860) 531-3224
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/03/2008
Last updated
06/07/2013
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