Provider Demographics
NPI:1942907654
Name:FLORA PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:FLORA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-522-7800
Mailing Address - Street 1:34 CRESCENT RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4509
Mailing Address - Country:US
Mailing Address - Phone:203-522-7800
Mailing Address - Fax:
Practice Address - Street 1:61 SHERMAN ST FL 2
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5891
Practice Address - Country:US
Practice Address - Phone:203-522-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT13457OtherPHYSICAL THERAPY BOARD OF CT