Healthcare Provider Details

I. General information

NPI: 1225344591
Provider Name (Legal Business Name): CORY A BILOW PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 08/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 TOM MILLER RD
PLATTSBURGH NY
12901-6426
US

IV. Provider business mailing address

PO BOX 2868
PLATTSBURGH NY
12901-0259
US

V. Phone/Fax

Practice location:
  • Phone: 518-562-4616
  • Fax: 518-562-7918
Mailing address:
  • Phone: 518-562-7900
  • Fax: 518-562-7933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032906
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: