Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jun 17, 2019
License(s)
044299 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 3990 RIVERSIDE PARK BLVD APT 1205 | Macon, GA 31210-1235 | 478-951-7037 |
| LOCATION | 468 LAFAYETTE AVE | Brooklyn, NY 11205-4809 | 718-399-6234 |
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