Professional Orthopedic and Sports Physical Therapy, PC

NPI #1396274460 in Bay Shore, New York

Provider Information

NPI Number: 1396274460
Entity Type: Organization
Organization Name: Professional Orthopedic and Sports Physical Therapy, PC
Primary Specialty: Physical Therapist
Enumeration Date: Jun 12, 2017
Last Updated: Apr 2, 2018

Practice Location

Address: 94 W MAIN ST
City: Bay Shore
State: New York
ZIP Code: 11706-8365
Phone: (631) 647-9124

Authorized Official

Name: KATHLEEN BRUSH
Title: CREDENTIALING MANAGER
Phone: (631) 359-5859

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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