Healthcare Provider Details

I. General information

NPI: 1740313691
Provider Name (Legal Business Name): PENN-TRAFFORD PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 HARRISON CITY EXPORT RD
HARRISON CITY PA
15636-1340
US

IV. Provider business mailing address

1004 HARRISON CITY EXPORT RD
HARRISON CITY PA
15636-1340
US

V. Phone/Fax

Practice location:
  • Phone: 724-744-7200
  • Fax:
Mailing address:
  • Phone: 724-744-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT007113L
License Number StatePA

VIII. Authorized Official

Name: MICHAEL W. HUFFMAN
Title or Position: CEO
Credential: PT
Phone: 724-744-7200