Provider Demographics
NPI:1568884864
Name:INDIVIDUAL PHYSICAL THERAPY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INDIVIDUAL PHYSICAL THERAPY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:TARSI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSPT, DIP MDT, OCS
Authorized Official - Phone:203-343-0357
Mailing Address - Street 1:100B DANBURY RD
Mailing Address - Street 2:STE 204
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-3711
Mailing Address - Country:US
Mailing Address - Phone:203-343-0357
Mailing Address - Fax:203-343-0358
Practice Address - Street 1:100 DANBURY RD BLDG B
Practice Address - Street 2:SUITE 204
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4107
Practice Address - Country:US
Practice Address - Phone:203-343-0357
Practice Address - Fax:203-343-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007612261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy