Organization
WELLNESS REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS QIAOLING LISA KUANG LMP (MEDICAL MASSAGE THERAPY)
(917) 379-7532
Entity
Organization
Contact information
Practice address
17227 128TH AVE, JAMAICA, NY 11434-3323
(718) 978-3389
Mailing address
17227 128TH AVE, JAMAICA, NY 11434-3323
(718) 978-3389
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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