Individual
BAKHOM MICHEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
899 BOWLING GREEN DR, WESTBURY, NY 11590-6103
(347) 656-6998
Mailing address
899 BOWLING GREEN DR, WESTBURY, NY 11590-6103
(347) 656-6998
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
033723
NY
Other
Enumeration date
09/28/2014
Last updated
12/31/2019
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