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General NPI Number Information
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NPI Number | 1558403980
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Entity Type | Organization
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Legal Business Name | LOWER MANHATTAN PHYSICAL THERAPY & SPORTS REHAB., P.C.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 09/28/2018
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Provider Practice Location Address
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Address Line | 177 E 87TH ST # 405
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City | NEW YORK
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State | NY
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Zip | 10128-2226
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Country | US
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Telephone | 212-249-0904
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Fax | 646-527-9021
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Provider Business Mailing Address
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Address Line | PO BOX 101
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City | SUWANEE
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State | GA
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Zip | 30024-0101
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Country | US
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Telephone | 678-571-3852
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Fax | 833-888-7868
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Authorized Official
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Title or Position | OWNER
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Name | MR. SEAN W WATERS
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Credential | M.S.,P.T.
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Telephone | 412-654-3212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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