Provider Demographics
NPI:1598055931
Name:JASON A CAMPOPIANO PT PLLC
Entity Type:Organization
Organization Name:JASON A CAMPOPIANO PT PLLC
Other - Org Name:LOCAL MOTION PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPOPIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-409-4288
Mailing Address - Street 1:PO BOX 3279
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-7279
Mailing Address - Country:US
Mailing Address - Phone:518-409-4288
Mailing Address - Fax:
Practice Address - Street 1:9 BROAD ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4301
Practice Address - Country:US
Practice Address - Phone:518-409-4288
Practice Address - Fax:518-409-4289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty