National Provider Identifier

Bethanny Jolly, PT, DPT

Bethanny Jolly, PT, DPT is listed in the NPPES registry with a primary specialty of Pediatric Physical Therapist in Newark, NY and a listed phone number of (315) 332-3328.

NPI 1912671116Newark, NYPediatric Physical Therapist

Profile Overview

NPI
1912671116
Provider Type
Individual
Primary Specialty
Pediatric Physical Therapist
Enumeration Date
August 03, 2021
Last Updated
August 03, 2021

Practice Location

  • 131 Drumlin Ct
  • Newark, NY 14513-1863

Phone: (315) 332-3328

Specialties

  • Pediatric Physical Therapist (2251P0200X)
Full Record
NPI
1912671116
Entity Type
Individual
Last Name
Jolly
First Name
Bethanny
Credential
PT, DPT
Mailing Street Address
131 Drumlin Ct
Mailing City
Newark
Mailing State
NY
Mailing ZIP Code
14513-1863
Mailing Country
US
Practice Street Address
131 Drumlin Ct
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513-1863
Practice Country
US
Practice Phone
(315) 332-3328
Enumeration Date
August 03, 2021
Last Updated
August 03, 2021
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
August 03, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatric Physical Therapist (2251P0200X)