Organization
PORT JEFFERSON PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER W WETSELL PHYSICAL THERAPIST (OWNER)
(631) 331-1070
Entity
Organization
Contact information
Practice address
300 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1227
(631) 331-1070
(631) 331-1126
Mailing address
300 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1227
(631) 331-1070
(631) 331-1126
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
002266
NY
Other
Enumeration date
03/12/2007
Last updated
08/22/2020
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