Individual ProviderTirzah Grace AntoinePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address85 Barnes Rd, Suite 109, Wallingford, CT 06492-1832(203) 697-1067PECOS EnrollmentBased on the most recent information from CMS, provider Tirzah Grace Antoine does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1508299496Provider TypeIndividualFull NameAntoine, Tirzah GraceTitleMrs.CredentialPTGenderFemaleSole ProprietorNoEnumeration Date8/14/2013Last Updated4/6/2016Contact InformationPractice LocationPractice Address85 Barnes Rd, Suite 109, Wallingford, CT 06492-1832Phone(203) 697-1067Fax(203) 284-0492Mailing LocationMailing Address85 Barnes Rd, Suite 109, Wallingford, CT 06492-1832Phone(203) 697-1067Fax(203) 284-0492Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense10703ConnecticutCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense036636New York