Provider Demographics
NPI:1457794331
Name:INERTIA OCCUPATIONAL AND PHYSICAL THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:INERTIA OCCUPATIONAL AND PHYSICAL THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:PANETTA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:315-404-7202
Mailing Address - Street 1:505 ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4515
Mailing Address - Country:US
Mailing Address - Phone:315-404-7202
Mailing Address - Fax:
Practice Address - Street 1:505 ROBERTS ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4515
Practice Address - Country:US
Practice Address - Phone:315-404-7202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty