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General NPI Number Information
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NPI Number | 1114263555
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Entity Type | Individual
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Provider Name | LAUREN KATHRYN ZIETSMAN PT
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Gender | Female
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 1868 E BEECHER HILL RD
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City | OWEGO
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State | NY
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Zip | 13827-3815
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Country | US
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Telephone | 877-426-3307
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Fax |
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Provider Business Mailing Address
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Address Line | 532 MURRAY HILL RD
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City | VESTAL
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State | NY
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Zip | 13850-3824
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Country | US
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Telephone | 315-396-4092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 035834
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 035834-1
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License Number State | NY
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