Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 034011-1 | NY |
NPI | 1194006395 |
---|---|
Provider Name | Mr. Philip Schultes |
First Address | Oneonta, NY 13820-2629 |
Second Address | Oneonta, NY 13820-2629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2011 |
Last Update Date | 31/08/2011 |