Provider Demographics
NPI:1205989175
Name:BETTS, WILLIAM JOSEPH (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:BETTS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 W MADISON AVE
Mailing Address - Street 2:PHYSICAL THERAPY DEPT
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-2806
Mailing Address - Country:US
Mailing Address - Phone:518-762-4548
Mailing Address - Fax:518-736-1570
Practice Address - Street 1:201 W MADISON AVE
Practice Address - Street 2:PHYSICAL THERAPY DEPT
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-2806
Practice Address - Country:US
Practice Address - Phone:518-762-4548
Practice Address - Fax:518-736-1570
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019556-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY353581OtherMVP
NY10035694OtherCDPHP
NYQ44191OtherEMPIRE BLUECROSS BLUESHIE
NY000491535001OtherBLUESHIELD NENY