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General NPI Number Information
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NPI Number | 1952627044
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Entity Type | Organization
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Legal Business Name | HOMER PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 84 CORTLAND ST
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City | HOMER
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State | NY
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Zip | 13077-1517
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Country | US
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Telephone | 607-749-2219
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Fax | 607-749-2286
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Provider Business Mailing Address
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Address Line | 84 CORTLAND ST
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City | HOMER
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State | NY
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Zip | 13077-1517
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Country | US
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Telephone | 607-749-2219
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Fax | 607-749-2286
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Authorized Official
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Title or Position | OWNER
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Name | MR. EHREN HEYER
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Credential | PT
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Telephone | 607-749-2219
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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 | 0258401
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License Number State | NY
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