Individual
BETHANNY JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
131 DRUMLIN CT, NEWARK, NY 14513-1863
(315) 332-3328
Mailing address
131 DRUMLIN CT, NEWARK, NY 14513-1863
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
046256
NY
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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