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Organization

BUFFALO TELETHERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMIE JOSEPH PARK DPT (OWNER/PHYSICAL THERAPIST)
(716) 949-8202
Entity
Organization

Contact information

Practice address
258 ASHLAND AVE, BUFFALO, NY 14222-1706
(716) 949-8202
Mailing address
258 ASHLAND AVE, BUFFALO, NY 14222-1706
(716) 949-8202

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
028310
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194818401
NPI
MD
Enumeration date
03/25/2016
Last updated
06/30/2016
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