Provider Demographics
NPI:1871332643
Name:MANUAL PHYSICAL THERAPY SPECIALISTS PLLC
Entity type:Organization
Organization Name:MANUAL PHYSICAL THERAPY SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, CFMT
Authorized Official - Phone:215-350-5181
Mailing Address - Street 1:15 BROMLEY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2933
Mailing Address - Country:US
Mailing Address - Phone:215-350-5181
Mailing Address - Fax:
Practice Address - Street 1:421 PENBROOKE DR STE 1
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2045
Practice Address - Country:US
Practice Address - Phone:215-350-5181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty