Healthcare Provider Details

I. General information

NPI: 1558320101
Provider Name (Legal Business Name): ONTARIO PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 06/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 RIDGE RD
ONTARIO NY
14519-9101
US

IV. Provider business mailing address

1272 RIDGE RD
ONTARIO NY
14519-9101
US

V. Phone/Fax

Practice location:
  • Phone: 315-524-9735
  • Fax: 315-524-4423
Mailing address:
  • Phone: 315-524-9735
  • Fax: 315-524-4423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. PAUL TOPOREK
Title or Position: OWNER
Credential: PT
Phone: 315-524-9735