Organization
INTEGRATED PHYSICAL THERAPY AND PAIN MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DJOANA CLARA HERRERA BAKANI RPT (PHYSICAL THERAPIST)
(203) 252-6989
Entity
Organization
Contact information
Practice address
67 HOLLY HILL LN STE 101, GREENWICH, CT 06830-6072
(203) 252-6989
Mailing address
20 BYRAM SHORE RD, GREENWICH, CT 06830-6926
(203) 252-6989
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
007561
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D400194066
PTAN
CT
Enumeration date
07/19/2014
Last updated
11/28/2022
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