Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Apr 23, 2013
License(s)
034946-1 (NY), PT32293 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1401 E 4TH AVE STE 201 | Hialeah, FL 33010-3504 | 786-259-0300 |
| MAILING | 3216 CRESCENT ST APT L1 | Astoria, NY 11106-4114 | 607-222-8794 |
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