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General NPI Number Information
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NPI Number | 1891247649
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Entity Type | Organization
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Legal Business Name | KING MYERS WOLF PHYSICAL & OCCUPATIONAL THERAPY PLLC
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 127 E 1ST ST
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City | OSWEGO
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State | NY
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Zip | 13126-2104
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Country | US
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Telephone | 315-207-2222
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Fax | 315-343-6923
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Provider Business Mailing Address
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Address Line | 127 E 1ST ST
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City | OSWEGO
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State | NY
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Zip | 13126-2104
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Country | US
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Telephone | 315-207-2222
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Fax | 315-343-6923
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MS. MICHELE R KING
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Credential |
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Telephone | 315-207-2222
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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