Provider Demographics
NPI:1073683199
Name:MORRISVILLE PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:MORRISVILLE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MAC
Authorized Official - Last Name:LAFRANCE
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:315-684-3393
Mailing Address - Street 1:PO BOX 995
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13408
Mailing Address - Country:US
Mailing Address - Phone:315-684-3393
Mailing Address - Fax:315-684-3394
Practice Address - Street 1:BIG M PLAZA 6 CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NY
Practice Address - Zip Code:13408
Practice Address - Country:US
Practice Address - Phone:315-684-3393
Practice Address - Fax:315-684-3394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1425OtherMEDICARE P-TAN