Provider First Line Business Practice Location Address:
4353 HYLAN BLVD
Provider Second Line Business Practice Location Address:
CO DEVITAL BECKER PHYSICAL THERAPY PC
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-967-3363
Provider Business Practice Location Address Fax Number:
718-967-5437
Provider Enumeration Date:
12/04/2006