Organization
BACK 2 SHAPE PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACHIAL KREYNER DPT (PRESIDENT)
(718) 909-5929
Entity
Organization
Contact information
Practice address
2411 EAST 2ND STREET, BROOKLYN, NY 11223-6041
(718) 909-5929
Mailing address
2411 EAST 2ND STREET, BROOKLYN, NY 11223-6041
(718) 909-5929
(718) 942-5753
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
036787
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225100000X
—
NY
Enumeration date
03/10/2014
Last updated
12/11/2015
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