NPI 1053760157

Brian R Wally, DPT

Practitioner Physical Therapist Glastonbury, CT

Practice location

Address: 2520 Main St STE 2, Glastonbury, CT 06033-4250
Phone: (860) 430-8383
Fax: (860) 856-6945
Mailing address: PO Box 417594, Boston, MA 02241-7594

Registered specialties (2)

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence 011339 (CT)

Other Physical Therapist providers in Connecticut →

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X Licence PT4733 (ME)

Registry record

NPI: 1053760157
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Jun 2016
Record last updated: 22 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.