Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Primary Physical Therapy PLLC

Organization Physical Therapist · NPI 1063735678

Primary Physical Therapy PLLC is a Physical Therapist in Waterville, New York. Registered with an NPI since 2010.

In the registry since
2010
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

358 Madison St
Waterville, NY 13480-1116
Phone: (315) 841-3222
Fax: (315) 841-4023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1063735678
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Hathaway — Owner/Pt · (315) 451-6541
Other names Proactive Physical Therapy
NPI enumeratedMarch 10, 2010
Last updated in NPPESJuly 1, 2010
Mailing address5496 E Taft Rd, Ste 2, North Syracuse, NY 13212-3784

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