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Organization

INTERACTIVE PHYSICAL THERAPY PLLC

Active
Other names
interactive physical therapy, pllc
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROMMEL B MIRANDO PT (OWNER MEMBER)
(718) 527-0698
Entity
Organization

Contact information

Practice address
13906 SPRINGFIELD BLVD, # 1 B, JAMAICA, NY 11413-2633
(718) 527-0698
(718) 527-0698
Mailing address
13906 SPRINGFIELD BLVD, # 1 B, JAMAICA, NY 11413-2633
(718) 527-0698
(718) 527-0698

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
12/18/2006
Last updated
08/09/2007
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