Professional Orthopedic and Sports Physical Therapy, P.c.

NPI #1790296135 in Bay Shore, New York

Provider Information

NPI Number: 1790296135
Entity Type: Organization
Organization Name: Professional Orthopedic and Sports Physical Therapy, P.c.
Primary Specialty: Physical Therapist
Enumeration Date: Oct 12, 2017
Last Updated: Apr 2, 2018

Practice Location

Address: 85 W MAIN ST STE 202
City: Bay Shore
State: New York
ZIP Code: 11706-8345
Phone: (631) 206-3130

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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