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General NPI Number Information
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NPI Number | 1720134471
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Entity Type | Organization
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Legal Business Name | MILESTONES PEDIATRICTHERAPY ,PLLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16783 IVES STREET EXT
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City | WATERTOWN
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State | NY
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Zip | 13601-5312
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Country | US
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Telephone | 315-788-5377
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Fax |
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Provider Business Mailing Address
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Address Line | 16783 IVES STREET EXT
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City | WATERTOWN
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State | NY
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Zip | 13601-5312
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Country | US
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Telephone | 315-788-5377
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. LYNN ANN AMELL
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Credential | OTR
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Telephone | 315-788-5377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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