Provider Demographics
NPI:1780820001
Name:CHERRY VALLEY PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:CHERRY VALLEY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PT, SCD, COMT
Authorized Official - Phone:315-815-4266
Mailing Address - Street 1:3959 MOSLEY RD
Mailing Address - Street 2:
Mailing Address - City:CAZENOVIA
Mailing Address - State:NY
Mailing Address - Zip Code:13035-9498
Mailing Address - Country:US
Mailing Address - Phone:315-815-4266
Mailing Address - Fax:315-815-4267
Practice Address - Street 1:75 NELSON ST
Practice Address - Street 2:TOWN & COUNTRY PLAZA
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035-1322
Practice Address - Country:US
Practice Address - Phone:315-815-4266
Practice Address - Fax:315-815-4267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6716261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy