Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 043038 | NY |
NPI | 1710452438 |
---|---|
Provider Name | Dr. Paul Colbert |
First Address | Potsdam, NY 13676-3320 |
Second Address | Potsdam, NY 13676-1799 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2018 |
Last Update Date | 09/10/2018 |