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Organization
HEALTH AQUATIC WELLNESS OF CHAUTAUQUA PHYSICAL THERAPY PLLC
Active
Organization
HEALTH AQUATIC WELLNESS OF CHAUTAUQUA PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY RISTAU (PART OWNER)
(814) 688-6119
Entity
Organization
Contact information
Practice address
3266 FLUVANNA AVENUE EXT, FLUVANNA, NY 14701-9706
(716) 708-6179
(716) 463-2228
Mailing address
3266 FLUVANNA AVENUE EXT, FLUVANNA, NY 14701-9706
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/20/2021
Last updated
09/02/2026
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