Individual
MR. MICHAEL JOSEPH WULFORST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
245 UNION AVE, HOLBROOK, NY 11741-1800
(631) 471-1335
Mailing address
15 STEWART ST, EAST ISLIP, NY 11730-1712
(631) 224-1266
(631) 224-1266
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000486-1
NY
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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