Healthcare Provider Details

I. General information

NPI: 1235102492
Provider Name (Legal Business Name): GARTH R ESPIGH MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7643 LAKE RAYSTOWN SHOPPING CTR
HUNTINGDON PA
16652-8403
US

IV. Provider business mailing address

5300 DERRY ST 2ND FLOOR
HARRISBURG PA
17111-3576
US

V. Phone/Fax

Practice location:
  • Phone: 814-643-2476
  • Fax: 814-643-6775
Mailing address:
  • Phone: 717-839-2110
  • Fax: 717-565-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9224
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT025198
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: