Provider Demographics
NPI:1366313330
Name:SOUTHBURY PHYSICAL THERAPY
Entity type:Organization
Organization Name:SOUTHBURY PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:603-580-3318
Mailing Address - Street 1:352 COBBLER LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-4641
Mailing Address - Country:US
Mailing Address - Phone:603-580-3318
Mailing Address - Fax:603-589-5075
Practice Address - Street 1:100 MAIN ST N UNIT 205
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-3842
Practice Address - Country:US
Practice Address - Phone:603-303-2390
Practice Address - Fax:603-580-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty