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Organization
L.I. PRO PHYSICAL THERAPY P.C.
Active
Organization
L.I. PRO PHYSICAL THERAPY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN ANDREW MINERVA DPT (OWNER)
(631) 873-6100
Entity
Organization
Contact information
Practice address
11 CANBY CT, WEST ISLIP, NY 11795-2309
(631) 873-6100
Mailing address
11 CANBY CT, WEST ISLIP, NY 11795-2309
(631) 873-6100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
031214-1
NY
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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