Healthcare Provider Details

I. General information

NPI: 1073698205
Provider Name (Legal Business Name): HANDS ON PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 N CAYUGA ST
ITHACA NY
14850-4329
US

IV. Provider business mailing address

215 N CAYUGA ST
ITHACA NY
14850-4329
US

V. Phone/Fax

Practice location:
  • Phone: 607-256-2603
  • Fax: 607-256-2603
Mailing address:
  • Phone: 607-256-2603
  • Fax: 607-256-2603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006640-1
License Number StateNY

VIII. Authorized Official

Name: BETH NADINE PARIS
Title or Position: OWNER
Credential: P.T., L.M.T.
Phone: 607-256-2603