Provider Demographics
NPI:1275848814
Name:CONTROLOGY PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:CONTROLOGY PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:ANNA
Authorized Official - Last Name:FALLON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:401-885-0051
Mailing Address - Street 1:20 REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-3219
Mailing Address - Country:US
Mailing Address - Phone:401-884-0051
Mailing Address - Fax:401-885-0054
Practice Address - Street 1:5600 POST RD
Practice Address - Street 2:SUITE 116
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3400
Practice Address - Country:US
Practice Address - Phone:401-885-0051
Practice Address - Fax:401-885-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy