Individual
CONNIE T BICKNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
190 MAIN ST, POTSDAM, NY 13676-2324
(315) 265-3990
(315) 265-3993
Mailing address
190 MAIN ST, P.O. BOX 998, POTSDAM, NY 13676-2324
(315) 265-3990
(315) 265-3993
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004765-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01466206
—
NY
Enumeration date
08/31/2006
Last updated
07/08/2007
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