Healthcare Provider Details

I. General information

NPI: 1104948371
Provider Name (Legal Business Name): HEALING SOLUTIONS PHYSICAL THERAPY, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 MASON ST
MORRISONVILLE NY
12962-2700
US

IV. Provider business mailing address

882 MASON ST
MORRISONVILLE NY
12962-2700
US

V. Phone/Fax

Practice location:
  • Phone: 518-561-6888
  • Fax:
Mailing address:
  • Phone: 518-561-6888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number008917-1
License Number StateNY

VIII. Authorized Official

Name: MS. SARA LYNN BROADWELL
Title or Position: PHYSICAL THERAPIST
Credential: PHYSICAL THERAPIST
Phone: 518-561-6888