Organization
DEVINE PHYSICAL THERAPY, ACUPUNCTURE AND MASSAGE THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER OLSEN P.T., D.P.T. (MANAGER)
(631) 320-1100
Entity
Organization
Contact information
Practice address
10 FORT SALONGA RD STE 2A, FORT SALONGA, NY 11768-1400
(631) 320-1100
(631) 343-7174
Mailing address
PMB 373, 186 SEVEN FARMS DRIVE, STE F, DANIEL ISLAND, SC 29492
(516) 662-9962
(631) 343-7174
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2017
Last updated
05/03/2019
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