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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 COORDINATOR MANAGER)
(718) 819-6805
Entity
Organization
Contact information
Practice address
55 E OLD COUNTRY RD, HICKSVILLE, NY 11801-4293
(516) 261-9750
(516) 261-9753
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
06/08/2016
Last updated
03/29/2018
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