Wholebody Wellness and Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

002520 Issued in CT

Legal business name

WHOLEBODY WELLNESS AND PHYSICAL THERAPY

Practice address

78 Eastern Blvd
Glastonbury, CT 06033-4325

Phone

(860) 916-5497

NPI assigned

Jun 20, 2014

Last updated

Jun 20, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carol M Gordon

Title

Owner

Phone

(860) 916-5497

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1558776203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 FOX DEN RD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334163",
            "telephone_number": "860-916-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 EASTERN BLVD",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334325",
            "telephone_number": "860-916-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLEBODY WELLNESS AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-916-5497"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "002520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric John Whidden, D.D.S.
• Elizabeth Anne White, RD
• Madison White
• William Robert White, ATC
• Molly H. Whitehouse, LCSW
• Joan Brady Wikholm, PT
• Jennifer Williams
• Shani Williams
• Sonja A. Williams, LPCA
• Hannah Wilson

• Physical Therapist in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Physical Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.