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Organization
PRIMARY PHYSICAL THERAPY PLLC
Active
Organization
PRIMARY PHYSICAL THERAPY PLLC
Active
Other names
PROActive Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY W HATHAWAY PT (OWNER/PT)
(315) 451-6541
Entity
Organization
Contact information
Practice address
792 N MAIN ST, STE 100C, NORTH SYRACUSE, NY 13212-1644
(315) 458-2552
(315) 458-2575
Mailing address
5496 E TAFT RD, STE 2, NORTH SYRACUSE, NY 13212-3784
(315) 451-6541
(315) 451-7059
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/10/2010
Last updated
07/01/2010
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