Healthcare Provider Details

I. General information

NPI: 1902835119
Provider Name (Legal Business Name): OT-PT CONNECTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W DOMINICK ST
ROME NY
13440-4816
US

IV. Provider business mailing address

405 W DOMINICK ST
ROME NY
13440-4816
US

V. Phone/Fax

Practice location:
  • Phone: 315-337-1533
  • Fax: 315-337-1531
Mailing address:
  • Phone: 315-337-1533
  • Fax: 315-337-1531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MS. HEATHER STEELE
Title or Position: OFFICE MANAGER
Credential:
Phone: 315-337-1533