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Individual

MICHELE JO PETHERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1300 FRANKLIN AVE, LL2, GARDEN CITY, NY 11530-5747
(516) 663-9099
(516) 663-9092
Mailing address
1300 FRANKLIN AVE, LL2, GARDEN CITY, NY 11530-5747
(516) 663-9099
(516) 663-9092

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
010022-1
NY
2251P0200X
Pediatric Physical Therapist
010022-1
NY
2251S0007X
Sports Physical Therapist
Primary
010022-1
NY
2251X0800X
Orthopedic Physical Therapist
010022-1
NY

Other

Enumeration date
11/15/2008
Last updated
08/05/2009
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