Shane Davis Physical Therapy Pc | |
13040 State Route 12, Boonville, NY 13309-4942 | |
(315) 358-4028 | |
(315) 358-4186 |
Full Name | Shane Davis Physical Therapy Pc |
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Type | Facility |
Speciality | Physical Therapist |
Location | 13040 State Route 12, Boonville, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679812747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 022935 (New York) | Primary |
Provider Name | Shane G Davis |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1033170725 PECOS PAC ID: 0840279634 Enrollment ID: I20040715000808 |
Mailing Address | Practice Location Address |
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Shane Davis Physical Therapy Pc 13040 State Route 12, Boonville, NY 13309-4942 Ph: (315) 358-4028 | Shane Davis Physical Therapy Pc 13040 State Route 12, Boonville, NY 13309-4942 Ph: (315) 358-4028 |
Shane Davis, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 13040 State Route 12, Boonville, NY 13309 Phone: 315-358-4028 Fax: 315-358-4186 | |
Dr. Elaine Marie Moore, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 110 Ford St, Boonville, NY 13309 Phone: 315-942-9220 | |
Sandra Patrick Beasock, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1591 Hines Rd, Boonville, NY 13309 Phone: 315-942-3101 |