Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jun 20, 2018
License(s)
031964 ()
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 6642 MYRTLE AVE | Glendale, NY 11385-7057 | 718-386-7000 |
| LOCATION | 6642 MYRTLE AVE | Glendale, NY 11385-7057 | 718-386-7000 |
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