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NPI Code Detail

MEDICARE: KATHRYN MISSERT DPT

MEDICARE:   KATHRYN  MISSERT  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist050837NY

General Provider Information

NPI Number : 1710761374
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN MISSERT DPT
Provider Business Mailing Address
First Line : 3190 NIAGARA FALLS BLVD STE 18
Second Line :
City : AMHERST
State : NY
Zip : 14228-1639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3190 NIAGARA FALLS BLVD STE 18
Second Line :
City : AMHERST
State : NY
Zip : 14228-1639
Country : US
Telephone Number : 716-418-7526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2023
Last Update Date : 08/23/2023

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Directions to “ KATHRYN MISSERT DPT” Practice Location

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