Provider First Line Business Practice Location Address:
2 WALTON WAY
Provider Second Line Business Practice Location Address:
LIGHTHOUSE PHYSICAL THERAPY, P.C.
Provider Business Practice Location Address City Name:
CORAM
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11727-1001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-440-7678
Provider Business Practice Location Address Fax Number:
631-331-0320
Provider Enumeration Date:
01/26/2007