{
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"OrgName": "NICKEL CITY PHYSICAL THERAPY P.C.",
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"FirstLineMailingAddress": "6255 SHERIDAN DR STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WILLIAMSVILLE",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14221-4825",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "716-689-6278",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6255 SHERIDAN DR STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WILLIAMSVILLE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "716-689-6278",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/13/2017",
"LastUpdateDate": "01/11/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROWAN",
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"AuthorizedOfficialNameSuffix": "IV",
"AuthorizedOfficialCredential": "PT, DPT",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "033023-1",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}