Organization
ACTIVE WELLNESS PHYSICAL THERAPY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABINIANO MANGGURAY (OWNER)
(718) 878-4103
Entity
Organization
Contact information
Practice address
100-05 ROOSEVELT AVE, 2ND FLOOR, CORONA, NY 11368
(718) 878-4103
(718) 803-6440
Mailing address
100-05 ROOSEVELT AVE, 2ND FLOOR, CORONA, NY 11368
(718) 878-4103
(718) 803-6440
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0314231
NY
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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