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General NPI Number Information
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NPI Number | 1831796713
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Entity Type | Organization
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Legal Business Name | QUALITY MOVEMENT RESTORATION, LLC
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 08/05/2023
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Provider Practice Location Address
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Address Line | 41 ATLANTIC AVE
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City | LYNBROOK
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State | NY
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Zip | 11563-3007
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Country | US
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Telephone | 718-283-4822
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Fax |
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Provider Business Mailing Address
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Address Line | 41 ATLANTIC AVE
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City | LYNBROOK
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State | NY
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Zip | 11563-3007
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Country | US
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Telephone | 718-283-4822
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Fax |
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Authorized Official
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Title or Position | CO-OWNER, PHYSICAL THERAPIST
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Name | LESLY DEVOLIERE JR
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Credential | PT, DPT
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Telephone | 718-283-4822
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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 |
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License Number State |
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