National Provider Identifier
Jac Samuel Dorris
Jac Samuel Dorris is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant in Lewiston, NY and a listed phone number of (716) 298-2900.
Profile Overview
- NPI
- 1407535693
- Provider Type
- Individual
- Primary Specialty
- Physical Therapy Assistant
- Enumeration Date
- July 14, 2023
- Last Updated
- July 14, 2023
Practice Location
- 5828 Lewiston Road
- Lewiston, NY 14092
Phone: (716) 298-2900
Mailing Address
- 262 Erin Road
- Medina, NY 14103
Specialties
- Physical Therapy Assistant (225200000X)
Full Record
- NPI
- 1407535693
- Entity Type
- Individual
- Last Name
- Dorris
- First Name
- Jac
- Middle Name
- Samuel
- Mailing Street Address
- 262 Erin Road
- Mailing City
- Medina
- Mailing State
- NY
- Mailing ZIP Code
- 14103
- Mailing Country
- US
- Mailing Phone
- (716) 940-3946
- Practice Street Address
- 5828 Lewiston Road
- Practice City
- Lewiston
- Practice State
- NY
- Practice ZIP Code
- 14092
- Practice Country
- US
- Practice Phone
- (716) 298-2900
- Enumeration Date
- July 14, 2023
- Last Updated
- July 14, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- July 10, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapy Assistant (225200000X)