| Theo Wilson, PT | |
|
16 Avery Hts, Hartford, CT 06106-4201 | |
| (347) 490-4333 | |
| Not Available |
| Full Name | Theo Wilson |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 16 Avery Hts, Hartford, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164851895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 008444 (Connecticut) | Primary |
| Provider Name | Life Home Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1467048777 PECOS PAC ID: 1254746340 Enrollment ID: O20210223002936 |
| Mailing Address | Practice Location Address |
|---|---|
| Theo Wilson, PT 16 Avery Hts, Hartford, CT 06106-4201 Ph: (347) 490-4333 | Theo Wilson, PT 16 Avery Hts, Hartford, CT 06106-4201 Ph: (347) 490-4333 |
Eastern Rehabilitation Network Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 85 Seymour Street- Suite604, Eastern Rehabilitation Network, Hartford, CT 06106 Phone: 860-545-5130 Fax: 860-545-1772 | |
Mark Richard Reynolds, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 36 Woodland St, Hartford, CT 06105 Phone: 860-522-2717 Fax: 860-240-7605 | |
Laurie S Cosenza, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 100 Retreat Ave, Suite 306, Hartford, CT 06106 Phone: 860-527-3097 Fax: 860-293-1010 | |
Ethan Aresta, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 550 Avery Hts, Hartford, CT 06106 Phone: 860-953-1201 | |
Marina Sasonov, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 580 Farmington Ave, Suite #101, Hartford, CT 06105 Phone: 860-570-0800 | |
Mr. Bruce Michael Worley Sr., PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 36 Woodland St, Hartford, CT 06105 Phone: 860-522-2717 Fax: 860-249-6164 | |
Greater Hartford Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 36 Woodland Street, Hartford, CT 06105 Phone: 860-522-2717 Fax: 860-240-7605 |