Organization
NIAGARA THERAPY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE LYNN MIODUSZEWSKI OTR/L (MANAGER/MEMBER)
(814) 464-0627
Entity
Organization
Contact information
Practice address
2631 W 8TH ST, ERIE, PA 16505-4034
(814) 464-0627
(814) 464-0629
Mailing address
2631 W 8TH ST, ERIE, PA 16505-4034
(814) 464-0627
(814) 464-0629
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
OC006865L
PA
Other
Enumeration date
10/16/2008
Last updated
04/02/2019
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