Provider Demographics
NPI:1205366168
Name:WESTERN CONNECTICUT PHYSICAL THERAPY
Entity Type:Organization
Organization Name:WESTERN CONNECTICUT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALORY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:RAMSDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:203-798-9702
Mailing Address - Street 1:2 RIVERVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:203-798-9702
Mailing Address - Fax:203-798-9208
Practice Address - Street 1:2 RIVERVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:203-798-9702
Practice Address - Fax:203-798-9208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001662OtherCT PHYSICAL THERAPY LICENSE