Organization
BUFFALO TELETHERAPY LLC
Active
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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