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General NPI Number Information
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NPI Number | 1891563664
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Entity Type | Organization
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Legal Business Name | ON TRACK PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 1042 UNIVERSITY AVE
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City | ROCHESTER
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State | NY
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Zip | 14607-1239
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Country | US
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Telephone | 315-729-9056
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Fax |
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Provider Business Mailing Address
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Address Line | 176 BERWICK RD
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City | ROCHESTER
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State | NY
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Zip | 14609-7707
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Country | US
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Telephone | 315-729-9056
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARLY GRAHAM
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Credential | DPT
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Telephone | 315-729-9056
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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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