Provider Demographics
NPI:1003439555
Name:PHYSIO STRENGTH PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:PHYSIO STRENGTH PHYSICAL THERAPY PLLC
Other - Org Name:PHYSIOSTRENGTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-816-6412
Mailing Address - Street 1:28 SEAVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1756
Mailing Address - Country:US
Mailing Address - Phone:917-816-6412
Mailing Address - Fax:
Practice Address - Street 1:28 SEAVIEW LN
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1756
Practice Address - Country:US
Practice Address - Phone:917-816-6412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty