Organization
PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARYN HAGLUND (CREDENTIALING COORDINATOR)
(631) 359-5780
Entity
Organization
Contact information
Practice address
20 COOK PLZ, MADISON, NJ 07940-1951
(973) 295-6460
(973) 943-4863
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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