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Organization

DYEVO PHYSICAL THERAPY, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHNNY CHANG DPT (OWNER)
(646) 493-9386
Entity
Organization

Contact information

Practice address
7412 88TH ST, GLENDALE, NY 11385-7952
(646) 493-9386
Mailing address
5 MICHAELS LN, GLEN HEAD, NY 11545-2014
(516) 424-3317

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
033956
NY

Other

Enumeration date
05/22/2013
Last updated
05/22/2013
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