Provider Demographics
NPI:1548967672
Name:MCKEE, LARRY WARD JR (PTA)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:WARD
Last Name:MCKEE
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:42 KUEBLER DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3939
Mailing Address - Country:US
Mailing Address - Phone:585-278-0477
Mailing Address - Fax:847-441-0734
Practice Address - Street 1:42 KUEBLER DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-3939
Practice Address - Country:US
Practice Address - Phone:585-278-0477
Practice Address - Fax:847-441-0734
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007883-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant