Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 025661-1 | NY |
NPI | 1083137418 |
---|---|
Provider Name | Mrs. Christine Marie Feely |
First Address | Trumansburg, NY 14886-9732 |
Second Address | Ithaca, NY 14850-3251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2017 |
Last Update Date | 18/07/2017 |