Organization
BACK TO HEALTH MEDICAL CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A HODES (SENIOR MANAGER)
(203) 381-9703
Entity
Organization
Contact information
Practice address
3355 MAIN ST, STRATFORD, CT 06614-4845
(203) 381-9703
(203) 381-9802
Mailing address
PO BOX 617, NAUGATUCK, CT 06770-0617
(203) 381-9703
(203) 381-9802
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010031532CT01
ANTHEM BLUE CROSS
CT
01
—
CV2485
ACS HEALTHNET
CT
01
—
P2185176
OXFORD
CT
Enumeration date
05/22/2006
Last updated
08/22/2020
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