Provider Demographics
NPI:1225754708
Name:T&M PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:T&M PHYSICAL THERAPY PLLC
Other - Org Name:SPORTSFOCUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-579-4340
Mailing Address - Street 1:531 VIRGINIA ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1450
Mailing Address - Country:US
Mailing Address - Phone:716-332-4838
Mailing Address - Fax:888-732-3062
Practice Address - Street 1:531 VIRGINIA ST STE 1
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1450
Practice Address - Country:US
Practice Address - Phone:716-332-4838
Practice Address - Fax:888-732-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty