Organization
SERENITY SOURCE PHYSICAL THERAPY, CHIROPRACTIC&MASSAGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIRDRE MCCOOL (BILLER)
(631) 404-7073
Entity
Organization
Contact information
Practice address
18 WEEKS ST STE A, BLUE POINT, NY 11715-1513
(631) 404-7073
(631) 751-8298
Mailing address
18 WEEKS ST STE A, BLUE POINT, NY 11715-1513
(631) 404-7073
(631) 751-8298
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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