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General NPI Number Information
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NPI Number | 1023072402
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Entity Type | Organization
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Legal Business Name | SOUTHVIEW PHYSICAL THERAPY AND SPORTS REHABILITATION,PC
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 880 WESTFALL RD SUITE D
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City | ROCHESTER
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State | NY
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Zip | 14618-2611
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Country | US
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Telephone | 585-271-3380
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Fax | 585-271-2728
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Provider Business Mailing Address
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Address Line | 880 WESTFALL RD SUITE D
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City | ROCHESTER
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State | NY
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Zip | 14618-2611
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Country | US
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Telephone | 585-271-3380
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Fax | 585-271-2728
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARIAN CARRACINO
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Credential | P.T.
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Telephone | 585-271-3380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5399
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License Number State | NY
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