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Organization
LAKE CHAMPLAIN PHYSICAL THERAPY PLLC
Active
Organization
LAKE CHAMPLAIN PHYSICAL THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARDO S LOPES-GOMES P.T. (OWNER/PHYSICAL THERAPIST)
(518) 597-3384
Entity
Organization
Contact information
Practice address
2786 MAIN ST, CROWN POINT, NY 12928
(518) 597-3384
Mailing address
2786MAIN STREET, CROWN POINT, NY 12928
(518) 597-4678
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
030350-1
NY
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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