Provider Demographics
NPI:1336225036
Name:WILTON PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:WILTON PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRABIEC
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:203-762-5623
Mailing Address - Street 1:23 HUBBARD RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3045
Mailing Address - Country:US
Mailing Address - Phone:203-762-5623
Mailing Address - Fax:203-762-9344
Practice Address - Street 1:23 HUBBARD RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3045
Practice Address - Country:US
Practice Address - Phone:203-762-5623
Practice Address - Fax:203-762-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V8285OtherHEALTHNET
CTANC1306OtherOXFORD
CTC02429Medicare PIN