Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING MANAGER)
(631) 359-5805
Entity
Organization
Contact information
Practice address
599 GRAMATAN AVE STE 205, FLEETWOOD, NY 10552
(914) 371-1990
(914) 371-7588
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0865
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/25/2018
Last updated
05/30/2018
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