Organization
LEGACY HEALTHCARE SERVICES
Active
Organization
LEGACY HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN BRADLEY FUNK PTA (PHYSICAL THERAPIST ASSISTANT)
(518) 320-5715
Entity
Organization
Contact information
Practice address
28 LINCOLN ST, HUDSON FALLS, NY 12839-2431
(518) 320-5715
Mailing address
28 LINCOLN ST, HUDSON FALLS, NY 12839-2431
(518) 320-5715
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5480
NC
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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