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General NPI Number Information
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NPI Number | 1922107960
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Entity Type | Organization
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Legal Business Name | MICHAEL P. HUSON PT, LLC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 675 W WASHINGTON ST
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City | GENEVA
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State | NY
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Zip | 14456-2119
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Country | US
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Telephone | 315-781-1144
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Fax | 315-781-0169
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Provider Business Mailing Address
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Address Line | 675 W WASHINGTON ST
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City | GENEVA
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State | NY
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Zip | 14456-2119
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Country | US
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Telephone | 315-781-1144
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Fax | 315-781-0169
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MR. MICHAEL PATRICK HUSON
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Credential | PT
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Telephone | 315-781-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 023660-1
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License Number State | NY
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