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Organization

LIFE PT ONLINE, P.L.L.C.

Active
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Organization

LIFE PT ONLINE, P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORETTA MARIE PECK PT (PHYSICAL THERAPIST/OWNER)
(631) 742-4282
Entity
Organization

Contact information

Practice address
199 ORCHARD RD, EAST PATCHOGUE, NY 11772-5510
(631) 742-4282
Mailing address
PO BOX 395, BROOKHAVEN, NY 11719-0395
(631) 742-4282

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
05/26/2020
Last updated
05/26/2020
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