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General NPI Number Information
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NPI Number | 1720392335
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Entity Type | Organization
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Legal Business Name | VIKI W. STORM,P.T. INC.
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 150 UNIVERSITY DR
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City | AMHERST
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State | MA
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Zip | 01002-2232
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Country | US
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Telephone | 413-256-8185
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Fax | 413-369-0282
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Provider Business Mailing Address
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Address Line | 134 RIVER ST. P.O.BOX 147
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City | CONWAY
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State | MA
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Zip | 01341
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Country | US
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Telephone | 413-369-4348
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Fax | 413-369-0282
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIKI STORM
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Credential | PT
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Telephone | 413-369-4348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 2193
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License Number State | MA
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