Healthcare Provider Details
I. General information
NPI: 1972565604
Provider Name (Legal Business Name): DRAYER PHYSICAL THERAPY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2006
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 PLAZA DR
CLEARFIELD PA
16830-6036
US
IV. Provider business mailing address
500 PLAZA DR
CLEARFIELD PA
16830-6036
US
V. Phone/Fax
- Phone: 814-762-8356
- Fax: 814-762-8366
- Phone: 814-762-8356
- Fax: 814-762-8366
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUKE
DRAYER
Title or Position: CEO
Credential:
Phone: 717-220-2100