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General NPI Number Information
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NPI Number | 1689922155
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Entity Type | Organization
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Legal Business Name | HORSEHEADS COMPREHENSIVE PHYSICAL THERAPY, PC, CORP
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 2758 WESTINGHOUSE RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-8115
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Country | US
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Telephone | 607-795-1539
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Fax | 607-795-1918
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Provider Business Mailing Address
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Address Line | 2758 WESTINGHOUSE RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-8115
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Country | US
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Telephone | 607-795-1539
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Fax | 607-795-1918
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Authorized Official
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Title or Position | OFFICE/BILLING MANAGER
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Name | KATHY MICHAELS
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Credential |
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Telephone | 607-795-1539
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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 | 014843-1
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License Number State | NY
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