Individual
KIERAN CLASEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
74 COMMERCE AVE STE 3, RIVERHEAD, NY 11901-3105
(631) 369-9110
(631) 369-9004
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
014318
NY
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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