Healthcare Provider Details

I. General information

NPI: 1881439552
Provider Name (Legal Business Name): WARRIOR SPORTS REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3316 5TH AVENUE STE 300
ALTOONA PA
16602
US

IV. Provider business mailing address

3316 5TH AVENUE STE 300
ALTOONA PA
16602
US

V. Phone/Fax

Practice location:
  • Phone: 814-626-8632
  • Fax:
Mailing address:
  • Phone: 814-626-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. TYLER MAGAHA
Title or Position: OWNER
Credential: DPT
Phone: 814-626-8632