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General NPI Number Information
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NPI Number | 1578582789
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Entity Type | Organization
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Legal Business Name | DEBRA Q. VIRTANEN
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 500 FEDERAL ST SUITE 302
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City | TROY
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State | NY
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Zip | 12180-2832
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Country | US
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Telephone | 518-272-3324
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Fax | 518-274-6904
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Provider Business Mailing Address
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Address Line | 500 FEDERAL ST SUITE 302
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City | TROY
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State | NY
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Zip | 12180-2832
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Country | US
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Telephone | 518-272-3324
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Fax | 518-274-6904
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA Q VIRTANEN
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Credential | MS,PT
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Telephone | 518-272-3324
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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 | 005954-1
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License Number State | NY
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