Provider Demographics
NPI:1700191038
Name:GRUBER, DARRELL (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:
Last Name:GRUBER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 NEWTON RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PLAISTOW
Mailing Address - State:NH
Mailing Address - Zip Code:03865-2440
Mailing Address - Country:US
Mailing Address - Phone:978-388-7272
Mailing Address - Fax:978-388-7373
Practice Address - Street 1:607 BANTAM RD STE H
Practice Address - Street 2:
Practice Address - City:BANTAM
Practice Address - State:CT
Practice Address - Zip Code:06750-1635
Practice Address - Country:US
Practice Address - Phone:860-567-7787
Practice Address - Fax:860-567-7779
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8882225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist