Provider Demographics
NPI:1861369258
Name:POPPY PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:POPPY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUMONT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:585-507-2747
Mailing Address - Street 1:12 GUILDER PL
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-2223
Mailing Address - Country:US
Mailing Address - Phone:585-507-2747
Mailing Address - Fax:585-507-2747
Practice Address - Street 1:12 GUILDER PL
Practice Address - Street 2:
Practice Address - City:BALLSTON LAKE
Practice Address - State:NY
Practice Address - Zip Code:12019-2223
Practice Address - Country:US
Practice Address - Phone:585-507-2747
Practice Address - Fax:585-507-2747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty