Provider Demographics
NPI:1922079672
Name:VALLEY PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:VALLEY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KREHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:315-495-2100
Mailing Address - Street 1:5156 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13409-4058
Mailing Address - Country:US
Mailing Address - Phone:315-495-2100
Mailing Address - Fax:315-495-2100
Practice Address - Street 1:5156 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13409-4058
Practice Address - Country:US
Practice Address - Phone:315-495-2100
Practice Address - Fax:315-495-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1629Medicare ID - Type UnspecifiedGROUP