Healthcare Provider Details

I. General information

NPI: 1932636917
Provider Name (Legal Business Name): PHYSIO SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20436 ROUTE 19 STE 106
CRANBERRY TOWNSHIP PA
16066-7541
US

IV. Provider business mailing address

20436 ROUTE 19 STE 106
CRANBERRY TOWNSHIP PA
16066-7541
US

V. Phone/Fax

Practice location:
  • Phone: 855-323-3654
  • Fax: 855-323-3654
Mailing address:
  • Phone: 855-323-3654
  • Fax: 855-323-3654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CHARLES BENJAMIN KRETCHEK
Title or Position: OWNER
Credential: DPT
Phone: 855-323-3654