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General NPI Number Information
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NPI Number | 1225754708
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Entity Type | Organization
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Legal Business Name | T&M PHYSICAL THERAPY PLLC DBA LAKE ERIE PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 531 VIRGINIA STREET STE 1
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City | BUFFALO
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State | NY
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Zip | 14202-1450
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Country | US
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Telephone | 716-332-4838
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Fax | 716-882-1200
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Provider Business Mailing Address
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Address Line | 531 VIRGINIA STREET STE 1
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City | BUFFALO
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State | NY
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Zip | 14202-1450
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Country | US
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Telephone | 716-332-4838
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Fax | 716-882-1200
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Authorized Official
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Title or Position | MEDICAL BILLING/CREDENTIALING
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Name | TAMMY ANN WUTZ
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Credential |
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Telephone | 716-332-4838
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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 |
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License Number State |
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