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Organization

180PHYSIOTHERAPY PT PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BORIS AVEZOV (PT/OWNER)
(347) 599-6099
Entity
Organization

Contact information

Practice address
6723 DARTMOUTH ST APT 3, FOREST HILLS, NY 11375-4052
(347) 599-6099
Mailing address
6723 DARTMOUTH ST APT 3, FOREST HILLS, NY 11375-4052
(347) 599-6099

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Enumeration date
06/06/2019
Last updated
06/06/2019
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