Healthcare Provider Details

I. General information

NPI: 1346303302
Provider Name (Legal Business Name): WEST END PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROUTE 209
KRESEGEVILLE PA
18333
US

IV. Provider business mailing address

RT 209 PO BOX 1020 WEST END PHYSICAL THERAPY INC
KRESGEVILLE GA
18333
US

V. Phone/Fax

Practice location:
  • Phone: 610-681-3637
  • Fax: 610-681-6344
Mailing address:
  • Phone: 610-681-3637
  • Fax: 610-681-6344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. STEVEN R LAZICKI
Title or Position: PHYSICAL THERAPIST OWNER
Credential: PT
Phone: 610-681-3627