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General NPI Number Information
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NPI Number | 1891221677
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY ALTERNATIVES
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 1 ASTOR AVE
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City | BROOKHAVEN
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State | NY
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Zip | 11719-9760
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Country | US
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Telephone | 151-667-8818
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Fax |
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Provider Business Mailing Address
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Address Line | 1 ASTOR AVE
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City | BROOKHAVEN
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State | NY
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Zip | 11719-9760
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Country | US
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Telephone | 151-667-8818
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, OWNER OPERATOR
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Name | MR. DONALD H. CAREY-SHAW
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Credential | PT, MS, LAC
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Telephone | 15166788187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 002588-1
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License Number State | NY
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