Provider Demographics
NPI:1194973081
Name:WALTER-FERRICK, JANICE (PT)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:WALTER-FERRICK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2309
Mailing Address - Country:US
Mailing Address - Phone:315-867-4412
Mailing Address - Fax:
Practice Address - Street 1:305 COOPER LN
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2309
Practice Address - Country:US
Practice Address - Phone:315-867-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013713-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist