MEDICARE: FULL RANGE PHYSICAL THERAPY SERVICES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1568620888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULL RANGE PHYSICAL THERAPY SERVICES, P.C.

Provider Business Mailing Address
First Line	:	135 CLOVE BRANCH RD
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-6109
Country	:	US
Telephone Number	:	845-223-7438
Fax Number	:	845-227-6439

Provider Business Practice Location Address
First Line	:	135 CLOVE BRANCH RD
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-6109
Country	:	US
Telephone Number	:	845-223-7438
Fax Number	:	845-227-6439

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. MELVIN CAVE
Credential	:	M.S., P.T.
Telephone Number	:	845-223-7438

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	05/23/2008

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