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Individual

MR. CHARLES DAVID PROSSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
304 FIRST ST, MULTISPORT PHYSICAL THERAPY AND FITNESS PLLC, LIVERPOOL, NY 13088
(315) 451-2270
(315) 451-2271
Mailing address
304 FIRST ST, MULTISPORT PHYSICAL THERAPY AND FITNESS PLLC, LIVERPOOL, NY 13088
(315) 451-2270
(315) 451-2271

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
017911
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RA5616
PIN
NY
Enumeration date
10/26/2006
Last updated
07/08/2007
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