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Organization
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Active
Organization
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (MANAGER OF CREDENTIALING)
(631) 359-5859
Entity
Organization
Contact information
Practice address
121 S MAIN ST STE B, LODI, NJ 07644-2244
(973) 313-8840
(973) 771-5366
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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