Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 026310-1 | NY |
NPI | 1023114840 |
---|---|
Provider Name | Dr. Michael Allen Anders |
First Address | Liverpool, NY 13088-6035 |
Second Address | Liverpool, NY 13088-6238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 27/01/2010 |