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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
JEFFREY W HATHAWAY PT, DPT (OWNER)
(315) 458-2552
Entity
Organization
Contact information
Practice address
1522 OLD BURRSTONE RD, UTICA, NY 13502-4804
(315) 841-3222
(315) 841-4023
Mailing address
792 N MAIN ST, STE D, NORTH SYRACUSE, NY 13212-1644
(315) 458-2552
(315) 458-2575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/09/2012
Last updated
03/09/2012
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