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General NPI Number Information
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NPI Number | 1477572980
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Entity Type | Organization
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Legal Business Name | BUFFALO BACK & NECK PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 1060 NIAGARA FALLS BLVD SUITE 5
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City | TONAWANDA
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State | NY
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Zip | 14150
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Country | US
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Telephone | 716-836-2225
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Fax | 716-836-2712
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Provider Business Mailing Address
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Address Line | 1060 NIAGARA FALLS BLVD SUITE 5
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City | TONAWANDA
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State | NY
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Zip | 14150
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Country | US
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Telephone | 716-836-2225
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Fax | 716-836-2712
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Authorized Official
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Title or Position | PRESIDENT -SECRETARY
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Name | DR. MATTHEW CHRISTOPHER SMITH
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Credential | PT, DPT,
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Telephone | 716-836-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 018465-1
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License Number State | NY
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