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NPI Code Detail

MEDICARE: SALLY COLL PT

MEDICARE: SALLY COLL PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical TherapistPT-005717-LPA
2225100000XPhysical TherapistPT005717LPA

General Provider Information

NPI Number : 1114980323
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY COLL PT
Provider Business Mailing Address
First Line : 625 WALNUT ST
Second Line :
City : MCKEESPORT
State : PA
Zip : 15132-2806
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 625 WALNUT ST
Second Line :
City : MCKEESPORT
State : PA
Zip : 15132-2806
Country : US
Telephone Number : 412-828-7965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/01/2021

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Directions to “ SALLY COLL PT” Practice Location

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