Provider Demographics
NPI:1952818361
Name:SHUMAN PHYSICAL THERAPY ASSOCIATES, PC
Entity Type:Organization
Organization Name:SHUMAN PHYSICAL THERAPY ASSOCIATES, PC
Other - Org Name:LATTIMORE ICEPLEX PT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-851-9987
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:NY
Mailing Address - Zip Code:14506-0664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2700 BRIGHTON HENRIETTA TOWN LINE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2716
Practice Address - Country:US
Practice Address - Phone:585-272-0188
Practice Address - Fax:585-424-3789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty