Provider Demographics
NPI:1609074848
Name:CORNERSTONE PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:CORNERSTONE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-263-3104
Mailing Address - Street 1:51 SHERMAN HILL RD
Mailing Address - Street 2:BUILDING A, SUITE 201
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3648
Mailing Address - Country:US
Mailing Address - Phone:203-263-3104
Mailing Address - Fax:203-263-4050
Practice Address - Street 1:51 SHERMAN HILL RD
Practice Address - Street 2:BUILDING A, SUITE 201
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3648
Practice Address - Country:US
Practice Address - Phone:203-263-3104
Practice Address - Fax:203-263-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty