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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
MICHELLE L STEARNS (VP ADMIN)
(315) 458-2552
Entity
Organization
Contact information
Practice address
792 N MAIN ST, SUITE 100C, NORTH SYRACUSE, NY 13212-1644
(315) 458-2552
(315) 458-2575
Mailing address
792 N MAIN ST, SUITE 100C, NORTH SYRACUSE, NY 13212-1644
(315) 458-2552
(315) 458-2575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000025332
BCBS CNY
NY
Enumeration date
02/08/2006
Last updated
09/10/2021
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