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Individual

JOHN F DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1061 N BROADWAY, N MASSAPEQUA, NY 11758-1853
(516) 454-6387
(516) 454-6387
Mailing address
18 HAMILTON PL, LAKE GROVE, NY 11755-1915
(516) 454-6387
(516) 454-6387

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
003072-1
NY

Other

Enumeration date
02/02/2009
Last updated
02/05/2009
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