Provider Demographics
NPI:1669443362
Name:RINDELL, TIFFANY (PT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:RINDELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:SHORELINE PHYSICAL THERAPY
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-0088
Mailing Address - Country:US
Mailing Address - Phone:860-739-4497
Mailing Address - Fax:860-739-7256
Practice Address - Street 1:131 BOSTON POST RD
Practice Address - Street 2:SHORELINE PHYSICAL THERAPY
Practice Address - City:EAST LYME
Practice Address - State:CT
Practice Address - Zip Code:06333-1605
Practice Address - Country:US
Practice Address - Phone:860-739-4497
Practice Address - Fax:860-739-7256
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006975225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist