Nicole Derue Physical Therapy P.c.

NPI 1053503185 - Clinic/Center - 261QP2000X

NPI Details
NPI 1053503185
Enumeration Date 08/13/2007
Last Updated 11/21/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name NICOLE BLYTHE NICOLE
Position PRESIDENT
Phone (315) 676-3826
Fax (315) 676-3402
Practice Location
573 S MAIN ST
CENTRAL SQUARE NY, 13036-9785, US
Phone (315) 676-3826
Fax (315) 676-3402
Business Location
573 S MAIN ST
CENTRAL SQUARE NY, 13036-9785, US
Phone (315) 676-3826
Fax (315) 676-3402
Toxanomy
Taxonomy Code 261QP2000X
License State New York
License Number 0590998
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According to our database, Nicole Derue Physical Therapy P.c. NPI is 1053503185, taxonomy code is 261QP2000X and license number is 0590998, license state is located at New York. Nicole Derue Physical Therapy P.c. physically located at 573 S Main St, Central Square NY, 13036-9785. NPI Number 1033115704 has the healthcare provider type.

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1053503185 NPI number is provided on an as is basis without warranty of any kind. 1053503185 is maintained by the National Plan & Provider Enumeration System. The contents of Nicole Derue Physical Therapy P.c. are for informational purposes only.