Provider Demographics
NPI:1033772637
Name:HEALTHTRAX PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:HEALTHTRAX PHYSICAL THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:413-563-7780
Mailing Address - Street 1:622 HEBRON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-5003
Mailing Address - Country:US
Mailing Address - Phone:413-563-7780
Mailing Address - Fax:
Practice Address - Street 1:3 WEYMOUTH RD
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-6006
Practice Address - Country:US
Practice Address - Phone:413-563-7780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy