Healthcare Provider Details

I. General information

NPI: 1083694145
Provider Name (Legal Business Name): KAISER PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 ELM ST
EAST AURORA NY
14052-2535
US

IV. Provider business mailing address

121 ELM ST
EAST AURORA NY
14052-2535
US

V. Phone/Fax

Practice location:
  • Phone: 716-652-1803
  • Fax: 716-652-1951
Mailing address:
  • Phone: 716-652-1803
  • Fax: 716-652-1951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6160
License Number StateNY

VIII. Authorized Official

Name: DR. SETH ALAN KAISER
Title or Position: OWNER AND PRESIDENT
Credential: DC PT
Phone: 716-652-1803