Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jun 10, 2009
License(s)
029838 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 16 GARDENIA LN | Hicksville, NY 11801-2009 | |
| LOCATION | 16 GARDENIA LN | Hicksville, NY 11801-2009 | 917-386-3434 |
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