Provider Demographics
NPI:1679756571
Name:FINGER LAKES WELLNESS CENTER AND HEALTH SPA
Entity type:Organization
Organization Name:FINGER LAKES WELLNESS CENTER AND HEALTH SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:OPILA-LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:607-776-3737
Mailing Address - Street 1:7531 COUNTY ROUTE 13
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810-7982
Mailing Address - Country:US
Mailing Address - Phone:607-776-3737
Mailing Address - Fax:607-776-7390
Practice Address - Street 1:7531 COUNTY ROUTE 13
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-7982
Practice Address - Country:US
Practice Address - Phone:607-776-3737
Practice Address - Fax:607-776-7390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2450261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation