Organization
OPTIMAL PHYSICAL THERAPY AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA LAVAWAY MSPT, OCS, COMT (PARTNER)
(203) 232-5924
Entity
Organization
Contact information
Practice address
168 CENTER STREET, SUITE 103, SOUTHINGTON, CT 06489-2572
(860) 604-6068
Mailing address
13 GREYSTONE, SHELTON, CT 06484-3832
(203) 858-6763
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
11/02/2017
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