Giles C Churchman, PTA

Individual provider Active NPI Physical Therapy Assistant · Hornell, NY

NPI 1447587076 · NPPES record last updated Nov 3, 2009

Key facts

NPI
1447587076
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
66007220 (NY)
Practice address
411 Canisteo St
Hornell, NY 14843-2104
Phone
(607) 324-8280
Fax
(607) 324-8283
NPI assigned
Nov 3, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
66007220NYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 66007220 NY Yes

Addresses

Primary practice location

411 Canisteo St
Hornell, NY 14843-2104

Mailing address

217 Vincent St
Hornell, NY 14843-1840
Phone (607) 382-5115

Other providers in Hornell, NY

All providers in Hornell, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.