1295912822 NPI number — WEISS PHYSICAL THERAPY ASSOCIATES

Table of content: (NPI 1295912822)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295912822 NPI number — WEISS PHYSICAL THERAPY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEISS PHYSICAL THERAPY ASSOCIATES
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:
6
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:
1295912822
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 E SIMPSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055-3456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-691-7100
Provider Business Mailing Address Fax Number:
717-691-6855

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 BENT CREEK BLVD
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17050-1870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-697-4000
Provider Business Practice Location Address Fax Number:
717-697-4004
Provider Enumeration Date:
01/25/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WEISS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
T
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
717-697-4000

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  PT016114-L , 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)

  • Identifier: 1811997091 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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