# SPROUT THERAPY GROUP - PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sprout Therapy Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114262318
- **Authorized official:** MR. JEFFREY S DORFMAN (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (315) 450-4898

## Contact information

- **Practice address:** 108 SOUTHVIEW RD, SYRACUSE, NY 13209-2206
- **Practice address phone:** (315) 450-4898
- **Practice address fax:** (315) 834-4898
- **Mailing address:** 108 SOUTHVIEW RD, SYRACUSE, NY 13209-2206
- **Mailing address phone:** (315) 450-4898
- **Mailing address fax:** (315) 834-4898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/29/2012
- **Last updated:** 11/29/2012