Healthcare Provider Details

I. General information

NPI: 1245059211
Provider Name (Legal Business Name): DR. HALEY FLOWER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 RIDGE RD
ONTARIO NY
14519-9101
US

IV. Provider business mailing address

7358 FURNACE RD
ONTARIO NY
14519-9723
US

V. Phone/Fax

Practice location:
  • Phone: 315-524-9735
  • Fax:
Mailing address:
  • Phone: 315-576-5897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number053256
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: