Organization
DIVERSIFIED PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE THIBEAULT PT (OWNER)
(203) 630-3939
Entity
Organization
Contact information
Practice address
1260 E MAIN ST, MERIDEN, CT 06450-4806
(203) 630-3939
Mailing address
1260 E MAIN ST, MERIDEN, CT 06450-4806
(203) 630-3939
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6033
CT
Other
Enumeration date
05/02/2007
Last updated
08/06/2007
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