Organization
CANTON-POTSDAM HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE L MATICE PTA (PHYSICAL THERAPIST ASSISTANT)
(315) 261-5490
Entity
Organization
Contact information
Practice address
80 E MAIN ST, CANTON, NY 13617-1450
(315) 261-5490
(315) 261-6490
Mailing address
281 LITTLE BOW RD, GOUVERNEUR, NY 13642-3154
(315) 287-0982
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
004071-1
NY
Other
Enumeration date
05/22/2007
Last updated
08/22/2020
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