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Organization

JELKAM PHYSICAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RANDALL FARDALE WIMBERLY MSPT (OWNER/ CEO)
(607) 349-8534
Entity
Organization

Contact information

Practice address
24 OAKRIDGE DR, BINGHAMTON, NY 13903-2125
(607) 349-8534
Mailing address
24 OAKRIDGE DR, BINGHAMTON, NY 13903-2125
(607) 349-8534

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
0218591
NY

Other

Enumeration date
06/17/2014
Last updated
11/12/2015
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