Provider Demographics
NPI:1114379062
Name:CHURCH HILL PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:CHURCH HILL PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:WEITEKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-426-8449
Mailing Address - Street 1:30 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1658
Mailing Address - Country:US
Mailing Address - Phone:203-426-8449
Mailing Address - Fax:203-426-8980
Practice Address - Street 1:30 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1658
Practice Address - Country:US
Practice Address - Phone:203-426-8449
Practice Address - Fax:203-426-8980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-04
Last Update Date:2016-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty