Provider Demographics
NPI:1477432003
Name:DEVELOPMENTAL THERAPY ASSOCIATES OCCUPATIONAL & PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:DEVELOPMENTAL THERAPY ASSOCIATES OCCUPATIONAL & PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:THALL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:315-749-3974
Mailing Address - Street 1:1964 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13318-1208
Mailing Address - Country:US
Mailing Address - Phone:315-749-3974
Mailing Address - Fax:
Practice Address - Street 1:1964 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13318-1208
Practice Address - Country:US
Practice Address - Phone:315-749-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy