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Individual

MR. BRIAN GODBOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
280 KESWICK DR, EAST ISLIP, NY 11730-3511
(917) 669-5402
Mailing address
280 KESWICK DRIVE, EAST ISLIP, NY 11730
(917) 669-5402

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
NY

Other

Enumeration date
02/12/2007
Last updated
07/21/2022
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