Healthcare Provider Details

I. General information

NPI: 1952492985
Provider Name (Legal Business Name): ARTHUR ROBERT MINERY PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 WASHINGTON ST SUITE A100
CHURCHVILLE NY
14428-9603
US

IV. Provider business mailing address

7 WASHINGTON ST SUITE A100
CHURCHVILLE NY
14428-9603
US

V. Phone/Fax

Practice location:
  • Phone: 585-293-9160
  • Fax: 585-293-9175
Mailing address:
  • Phone: 585-293-9160
  • Fax: 585-293-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number024288-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: