Provider Demographics
NPI:1154065563
Name:CARDIO PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:CARDIO PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOORHEES
Authorized Official - Suffix:
Authorized Official - Credentials:PT CCS, CCRP
Authorized Official - Phone:716-650-0590
Mailing Address - Street 1:PO BOX 377
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-0377
Mailing Address - Country:US
Mailing Address - Phone:716-650-0590
Mailing Address - Fax:
Practice Address - Street 1:9450 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2216
Practice Address - Country:US
Practice Address - Phone:716-650-0590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty