Organization
PATH 2 SELF PERFORMANCE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY CHARLES BECKWITH PTA (OWNER)
(860) 908-6139
Entity
Organization
Contact information
Practice address
1663 ROUTE 12, GALES FERRY, CT 06335-1500
(860) 908-6139
Mailing address
1663 ROUTE 12, GALES FERRY, CT 06335-1500
(860) 908-6139
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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