Provider Demographics
NPI:1679956288
Name:OPALECKY PHYSICAL THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:OPALECKY PHYSICAL THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:OPALECKY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:585-520-6067
Mailing Address - Street 1:965 KENT RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:NY
Mailing Address - Zip Code:14477-9616
Mailing Address - Country:US
Mailing Address - Phone:585-520-6067
Mailing Address - Fax:585-520-6067
Practice Address - Street 1:965 KENT RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:NY
Practice Address - Zip Code:14477-9616
Practice Address - Country:US
Practice Address - Phone:585-520-6067
Practice Address - Fax:585-520-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty