1326284639 NPI number — PERSONAL TOUCH PHYSICAL THERAPY, LLC

Table of content: (NPI 1326284639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326284639 NPI number — PERSONAL TOUCH PHYSICAL THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERSONAL TOUCH PHYSICAL THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326284639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVANS CITY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16033-1253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-432-3402
Provider Business Mailing Address Fax Number:
724-432-3403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVANS CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16033-1253
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-432-3402
Provider Business Practice Location Address Fax Number:
724-432-3403
Provider Enumeration Date:
12/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHADRAN
Authorized Official First Name:
ACHJAN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BUSINESS OWNER
Authorized Official Telephone Number:
724-432-3402

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT006189L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)