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Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC
Active
Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING MANAGER)
(631) 359-5859
Entity
Organization
Contact information
Practice address
8989 UNION TPKE, GLENDALE, NY 11385-8010
(718) 819-6805
(347) 841-9109
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/18/2017
Last updated
04/03/2018
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