Organization
THERPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR SHEVARDNADZE DPT (CHIEF OPERATING OFFICER)
(908) 447-5260
Entity
Organization
Contact information
Practice address
1110 42ND ST, BROOKLYN, NY 11219-1213
(908) 447-5260
Mailing address
1110 42ND ST, BROOKLYN, NY 11219-1213
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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