Organization
PRO SPORTS PERFORMANCE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GEORGE PETERS PT (PRESIDENT/OWNER)
(516) 510-3713
Entity
Organization
Contact information
Practice address
190 BROADWAY, GARDEN CITY PARK, NY 11040-5333
(516) 510-3713
(516) 246-2869
Mailing address
211 FERNWOOD TER, STEWART MANOR, NY 11530-5011
(516) 510-3713
(516) 248-2869
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
029855
NY
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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