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Organization
MARANATHA FAMILY CENTER, LLC
Active
Organization
MARANATHA FAMILY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STELLA T MCKENNA PT (OWNER/ PHYSICAL THERAPIST)
(518) 234-2868
Entity
Organization
Contact information
Practice address
1461 STATE ROUTE 7, RICHMONDVILLE, NY 12149-2305
(518) 234-2868
(518) 254-7050
Mailing address
1461 STATE ROUTE 7, RICHMONDVILLE, NY 12149-2305
(518) 234-2868
(518) 254-7050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006533-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01358983
—
NY
Enumeration date
08/08/2013
Last updated
08/08/2013
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