Serenity Source Physical Therapy, Chiropractic&massage Pllc

NPI #1093117202 in Blue Point, New York

Provider Information

NPI Number: 1093117202
Entity Type: Organization
Organization Name: Serenity Source Physical Therapy, Chiropractic&massage Pllc
Primary Specialty: Physical Medicine & Rehabilitation
Enumeration Date: Sep 18, 2014
Last Updated: Sep 18, 2014

Practice Location

Address: 18 WEEKS ST STE A
City: Blue Point
State: New York
ZIP Code: 11715-1513
Phone: (631) 404-7073

Authorized Official

Name: DEIRDRE MCCOOL
Title: BILLER
Phone: (631) 404-7073

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Physical Medicine & Rehabilitation	208100000X	Primary

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