Provider Demographics
NPI:1760589675
Name:PHYSICAL THERAPY CENTER OF ROCKY HILL, LLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY CENTER OF ROCKY HILL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PAHOLSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:860-513-1431
Mailing Address - Street 1:2162 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2315
Mailing Address - Country:US
Mailing Address - Phone:860-513-1431
Mailing Address - Fax:860-529-0126
Practice Address - Street 1:2162 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2315
Practice Address - Country:US
Practice Address - Phone:860-513-1431
Practice Address - Fax:860-529-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003192225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty