Organization
MEADOWBROOK CENTER INC
Active
Other names
MeadowBrook of Granby
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON DAVANZO (ADMINISTRATOR)
(860) 653-9888
Entity
Organization
Contact information
Practice address
350 SALMON BROOK ST, GRANBY, CT 06035-1842
(860) 653-9888
(860) 653-8938
Mailing address
350 SALMON BROOK ST, GRANBY, CT 06035-1842
(860) 653-9888
(860) 653-8938
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2080C
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000020800
—
CT
Enumeration date
11/09/2011
Last updated
11/09/2011
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