Healthcare Provider Details

I. General information

NPI: 1740112523
Provider Name (Legal Business Name): TWIN VALLEY PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 OLEAN PORTVILLE RD
OLEAN NY
14760
US

IV. Provider business mailing address

936 FORNESS AVE
OLEAN NY
14760-3027
US

V. Phone/Fax

Practice location:
  • Phone: 814-516-5032
  • Fax:
Mailing address:
  • Phone: 814-516-5032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: EHRIN LEE
Title or Position: PHYSICAL THERAPY
Credential: DPT
Phone: 814-516-5032