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Organization
JUST PHYSICAL THERAPY PC
Active
Organization
JUST PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RENE REVILLAS PT (PRESIDENT)
(315) 561-1817
Entity
Organization
Contact information
Practice address
8441 130TH ST, KEW GARDENS, NY 11415-2812
(315) 561-1817
Mailing address
8441 130TH ST, KEW GARDENS, NY 11415-2812
(315) 561-1817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
031838
NY
Other
Enumeration date
01/18/2016
Last updated
04/05/2016
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