Formula for Performance & Rehab, LLC

NPI #1992114508 in Weston, Connecticut

Provider Information

NPI Number: 1992114508
Entity Type: Organization
Organization Name: Formula for Performance & Rehab, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Aug 7, 2014
Last Updated: Aug 29, 2014

Practice Location

Address: 59 VALLEY FORGE RD
City: Weston
State: Connecticut
ZIP Code: 06883-1912
Phone: (203) 227-6666

Authorized Official

Name: NICHOLAS CORWIN
Title: MANAGING DIRECTOR
Phone: (203) 247-2270

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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