Healthcare Provider Details

I. General information

NPI: 1255380531
Provider Name (Legal Business Name): PAUL ROCKAR PT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 WALNUT ST
MCKEESPORT PA
15132-2806
US

IV. Provider business mailing address

3911 MURRY HIGHLANDS CIR
MURRYSVILLE PA
15668-1734
US

V. Phone/Fax

Practice location:
  • Phone: 412-673-6660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT003069L
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: