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Organization
LONG ISLAND PREMIER PHYSICAL & AQUATIC THERAPY LLC
Active
Organization
LONG ISLAND PREMIER PHYSICAL & AQUATIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON SPAHN DPT (OWNER/THERAPIST)
(631) 991-3311
Entity
Organization
Contact information
Practice address
155 W SUNRISE HWY, LINDENHURST, NY 11757-2435
(631) 991-3311
Mailing address
155 W SUNRISE HWY, LINDENHURST, NY 11757-2434
(631) 991-3311
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
029010-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q076C1
BCBS
NY
Enumeration date
02/24/2009
Last updated
04/07/2015
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