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Contact Information

BOLTON PHYSICAL THERAPY & SPORTS PERFORMANCE LLC
921 BOSTON TURNPIKE
BOLTON, CT06043
 Phone: 860-646-8758
 Fax: 860-646-0256
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy

261QP2000X
Indicates primary specialty

NPI Profile & details for BOLTON PHYSICAL THERAPY & SPORTS PERFORMANCE LLC

NPI Number 1265650188
LBN Legal business name BOLTON PHYSICAL THERAPY & SPORTS PERFORMANCE LLC
Authorized official BRUCE LANGEVIN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/23/2007
Last updated 07/13/2012 - About 14 years ago
Identifiers
CT License # 005532
CT Other 080005532CT08 BLUE CROSS BLE SHIELD
CT Other 44901 ORTHONET CIGNA
CT Other 0044901 ORTHONET HEALTHNET
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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