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General NPI Number Information
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NPI Number | 1174672950
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Entity Type | Organization
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Legal Business Name | SENECA PHYSICAL THERAPY OF THE FINGER LAKES, PC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 609 N FRANKLIN ST
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City | WATKINS GLEN
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State | NY
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Zip | 14891-1302
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Country | US
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Telephone | 607-535-7475
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Fax |
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Provider Business Mailing Address
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Address Line | 609 N FRANKLIN ST
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City | WATKINS GLEN
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State | NY
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Zip | 14891-1302
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Country | US
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Telephone | 607-535-7475
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. AMANDA SMITH-SOCARIS
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Credential | PT, MS, OCS, CSCS
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Telephone | 607-535-7475
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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 | 018951-1
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License Number State | NY
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