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General NPI Number Information
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NPI Number | 1750761730
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Entity Type | Organization
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Legal Business Name | JL HOME PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 82 HOBSON AVE
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City | SAINT JAMES
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State | NY
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Zip | 11780-3028
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Country | US
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Telephone | 631-343-3147
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Fax | 631-343-3148
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Provider Business Mailing Address
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Address Line | PO BOX 2238
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City | SAINT JAMES
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State | NY
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Zip | 11780-0608
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Country | US
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Telephone | 631-343-3147
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Fax | 631-343-3148
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Authorized Official
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Title or Position | MEMBER
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Name | JANINE A SPIEZIO
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Credential | MPT
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Telephone | 631-343-3147
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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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