Provider Demographics
NPI:1225754708
Name:T&M PHYSICAL THERAPY PLLC DBA LAKE ERIE PHYSICAL THERAPY
Entity type:Organization
Organization Name:T&M PHYSICAL THERAPY PLLC DBA LAKE ERIE PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-332-4838
Mailing Address - Street 1:531 VIRGINIA STREET STE 1
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1450
Mailing Address - Country:US
Mailing Address - Phone:716-332-4838
Mailing Address - Fax:716-882-1200
Practice Address - Street 1:531 VIRGINIA STREET STE 1
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-1450
Practice Address - Country:US
Practice Address - Phone:716-332-4838
Practice Address - Fax:716-882-1200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty