Organization
STRIDE PHYSICAL THERAPY AND PEDORTHIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA T NOLE MA PT CPC (PRESIDENT)
(203) 758-8307
Entity
Organization
Contact information
Practice address
80 TURNPIKE DR, UNIT 1, MIDDLEBURY, CT 06762-1830
(203) 758-8307
(203) 758-8394
Mailing address
80 TURNPIKE DR, UNIT 1, MIDDLEBURY, CT 06762-1830
(203) 758-8307
(203) 758-8394
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
003621
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004137338
—
CT
01
—
080003621CT02
ANTHEM
CT
Enumeration date
04/03/2007
Last updated
10/05/2016
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