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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)
(718) 819-6805
Entity
Organization
Contact information
Practice address
74 COMMERCE AVE STE 3, RIVERHEAD, NY 11901-3105
(631) 369-9110
Mailing address
2142 UTOPIA PKWY, WHITESTONE, NY 11357-4142
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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