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General NPI Number Information
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NPI Number | 1023520871
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Entity Type | Organization
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Legal Business Name | ATHLETES PERFORMANCE CARE
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 112 ELM ST
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City | SAYVILLE
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State | NY
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Zip | 11782-3125
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Country | US
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Telephone | 631-235-1020
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Fax | 631-563-7599
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Provider Business Mailing Address
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Address Line | 112 ELM ST
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City | SAYVILLE
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State | NY
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Zip | 11782-3125
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Country | US
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Telephone | 631-235-1020
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Fax | 631-563-7599
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Authorized Official
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Title or Position | PRINCIPLE
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Name | MR. TERRY STEIN
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Credential | LMT
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Telephone | 631-235-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 023365
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License Number State | NY
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