Provider Demographics
NPI:1871685388
Name:ORTHOPEDIC & SPINE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:ORTHOPEDIC & SPINE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUHER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:518-793-0891
Mailing Address - Street 1:3 HUNTER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5858
Mailing Address - Country:US
Mailing Address - Phone:518-793-0891
Mailing Address - Fax:518-793-2936
Practice Address - Street 1:3 HUNTER BROOK LN
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5858
Practice Address - Country:US
Practice Address - Phone:518-793-0891
Practice Address - Fax:518-793-2936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q8W382OtherBLUECROSS
Q8W382OtherBLUECROSS