Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING COORDINATOR MANAGER)
(631) 359-5859
Entity
Organization
Contact information
Practice address
329 RIVERSIDE AVE, WESTPORT, CT 06880-4810
(203) 557-6477
(203) 557-6481
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
03/29/2018
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