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Organization
THREE PEAKS PHYSICAL THERAPY
Active
Organization
THREE PEAKS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA LYNN SHEPPARD DPT (DIRECTOR)
(631) 226-2918
Entity
Organization
Contact information
Practice address
375 MAIN ST, SUITE 1A, ISLIP, NY 11751-3542
(631) 226-2918
(631) 226-2746
Mailing address
PO BOX 607, ISLIP, NY 11751-0607
(631) 226-2918
(631) 226-2746
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016755
NY
225100000X
Physical Therapist
029690
NY
225100000X
Physical Therapist
032701
NY
225100000X
Physical Therapist
3322
CO
225700000X
Massage Therapist
008590
NY
225700000X
Massage Therapist
013122
NY
225700000X
Massage Therapist
10424
CO
Other
Enumeration date
12/22/2008
Last updated
10/01/2010
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