Chastian Powers

Individual provider Active NPI Physical Therapist · West Hartford, CT

NPI 1043935679 · NPPES record last updated Oct 6, 2022

Key facts

NPI
1043935679
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
635 New Park Ave
West Hartford, CT 06110-1329
Phone
(860) 964-0677
NPI assigned
Oct 6, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

635 New Park Ave
West Hartford, CT 06110-1329

Mailing address

218 Trout Brook Dr
West Hartford, CT 06110-1236

Other providers in West Hartford, CT

All providers in West Hartford, CT · Physical Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.