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NPI Code Detail

MEDICARE: PRANA FUNCTIONAL MANUAL THERAPY, LLC

MEDICARE: PRANA FUNCTIONAL MANUAL THERAPY, LLC
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
1261QP2000XPhysical Therapy Clinic/CenterPT017185PA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5181523OTHERPAMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21949525OTHERPAHIGHMARK BLUE SHIELD
320088797OTHERPAAMERIHEALTH MERCY
450093252OTHERPACAPITAL BLUE CROSS
650081775OTHERPACAPITAL BLUE CROSS PIN
71646932OTHERPAHIGHMARK BLUE SHIELD
820080890OTHERPAAMERIHEALTH MERCY

General Provider Information

NPI Number : 1356660146
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRANA FUNCTIONAL MANUAL THERAPY, LLC
Provider Business Mailing Address
First Line : 617 N PRINCE ST
Second Line : MAILBOX A
City : LANCASTER
State : PA
Zip : 17603-4769
Country : US
Telephone Number : 717-390-4822
Fax Number : 717-390-4825
Provider Business Practice Location Address
First Line : 617 N PRINCE ST
Second Line :
City : LANCASTER
State : PA
Zip : 17603-4769
Country : US
Telephone Number : 717-390-4822
Fax Number : 717-390-4825
Authorized Official
Title or Position : OWNER, PHYSICAL THERAPIST
Name : DAWN MARIE COX
Credential : CFMT, MSPT
Telephone Number : 717-390-4822
Provider Enumeration Date : 05/19/2010
Last Update Date : 06/29/2016

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