Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING MANAGER)
(718) 819-6805
Entity
Organization
Contact information
Practice address
3530 POST RD, SUITE 202, SOUTHPORT, CT 06890-1169
(203) 307-4600
(203) 307-4601
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/06/2016
Last updated
03/29/2018
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