Provider Demographics
NPI:1437294576
Name:SELECT ORTHOPEDICS, LLC
Entity Type:Organization
Organization Name:SELECT ORTHOPEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:860-522-2717
Mailing Address - Street 1:40 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-2327
Mailing Address - Country:US
Mailing Address - Phone:860-522-2717
Mailing Address - Fax:860-249-6164
Practice Address - Street 1:40 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2327
Practice Address - Country:US
Practice Address - Phone:860-242-1003
Practice Address - Fax:860-242-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty