Provider Demographics
NPI:1992723837
Name:CALLAN HARRIS PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:CALLAN HARRIS PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CALLAN HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PT MS LLCC
Authorized Official - Phone:585-482-5060
Mailing Address - Street 1:1328 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1622
Mailing Address - Country:US
Mailing Address - Phone:585-482-5060
Mailing Address - Fax:585-482-7982
Practice Address - Street 1:1328 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1622
Practice Address - Country:US
Practice Address - Phone:585-482-5060
Practice Address - Fax:585-482-7982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty