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General NPI Number Information
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NPI Number | 1184929440
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Entity Type | Organization
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Legal Business Name | ALL-STAR PHYSCIAL THERAPY OF SEAFORD P.C.
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 3839 MERRICK RD
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City | SEAFORD
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State | NY
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Zip | 11783-2839
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Country | US
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Telephone | 516-802-2895
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Fax | 516-802-2897
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Provider Business Mailing Address
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Address Line | 3839 MERRICK RD
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City | SEAFORD
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State | NY
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Zip | 11783-2839
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Country | US
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Telephone | 516-802-2895
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Fax | 516-802-2897
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MR. CHRISTOPHER KIMBALL
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Credential | P.T.
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Telephone | 516-802-2895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 021476
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License Number State | NY
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