Provider Demographics
NPI:1962709428
Name:MILLBROOK PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:MILLBROOK PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:BREMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:845-677-5021
Mailing Address - Street 1:2 FRONT ST
Mailing Address - Street 2:PO BOX 1464
Mailing Address - City:MILLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:12545-5948
Mailing Address - Country:US
Mailing Address - Phone:845-677-5021
Mailing Address - Fax:845-677-3117
Practice Address - Street 1:2 FRONT ST
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545-5948
Practice Address - Country:US
Practice Address - Phone:845-677-5021
Practice Address - Fax:845-677-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty