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General NPI Number Information
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NPI Number | 1184143844
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Entity Type | Organization
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Legal Business Name | NICKEL CITY PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 6255 SHERIDAN DR STE 100
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4825
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Country | US
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Telephone | 716-689-6278
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Fax |
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Provider Business Mailing Address
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Address Line | 6255 SHERIDAN DR STE 100
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4825
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Country | US
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Telephone | 716-689-6278
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Fax |
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Authorized Official
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Title or Position | OWNER / PHYSICAL THERAPIST
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Name | MYLES W ROWAN IV
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Credential | PT, DPT
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Telephone | 716-689-6278
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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 | 033023-1
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License Number State | NY
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