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General NPI Number Information
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NPI Number | 1134676893
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Entity Type | Organization
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Legal Business Name | MEGAMOTION PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/09/2016
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 3514 CRAIG RD
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City | CLINTON
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State | NY
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Zip | 13323-3912
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Country | US
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Telephone | 352-293-5803
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Fax |
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Provider Business Mailing Address
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Address Line | 3514 CRAIG RD
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City | CLINTON
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State | NY
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Zip | 13323-3912
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PT, DPT
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Name | JEORGE ARCELLANA
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Credential |
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Telephone | 353-293-5803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 028578
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License Number State | NY
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