Healthcare Provider Details

I. General information

NPI: 1376508077
Provider Name (Legal Business Name): HUGHES PHYSICAL THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3802 STATE ROUTE 31 SUITE 2
DONEGAL PA
15628-4033
US

IV. Provider business mailing address

420 FOREST RD
ACME PA
15610-1218
US

V. Phone/Fax

Practice location:
  • Phone: 724-593-8880
  • Fax: 724-593-8882
Mailing address:
  • Phone: 724-547-3657
  • Fax: 724-547-5586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT015390
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC001781L
License Number StatePA

VIII. Authorized Official

Name: MR. MARK GREGORY HUGHES
Title or Position: PRESIDENT AND OWNER
Credential: PT
Phone: 724-593-8880