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General NPI Number Information
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NPI Number | 1578018255
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Entity Type | Organization
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Legal Business Name | GLOVER PHYSICAL THERAPY
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 3620 HARLEM RD SUITE 2
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City | CHEEKTOWAGA
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State | NY
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Zip | 14215-2042
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Country | US
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Telephone | 716-446-9500
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Fax | 716-446-9501
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Provider Business Mailing Address
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Address Line | 3620 HARLEM RD SUITE 2
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City | CHEEKTOWAGA
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State | NY
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Zip | 14215-2042
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Country | US
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Telephone | 716-446-9500
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Fax | 716-446-9501
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | BRIAN KEITH GLOVER
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Credential | PT
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Telephone | 716-446-9500
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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 | 62040688
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License Number State | NY
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