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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) 359-5805
Entity
Organization
Contact information
Practice address
22005 HILLSIDE AVE, C/O BLINK, QUEENS VILLAGE, NY 11427-2033
(718) 400-8330
(718) 400-8340
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
06/08/2019
Last updated
06/08/2019
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