Healthcare Provider Details

I. General information

NPI: 1871993667
Provider Name (Legal Business Name): COLLEEN CIMBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2014
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 LOGAN FERRY RD
MURRYSVILLE PA
15668-1205
US

IV. Provider business mailing address

3300 LOGAN FERRY RD
MURRYSVILLE PA
15668-1205
US

V. Phone/Fax

Practice location:
  • Phone: 724-325-1500
  • Fax:
Mailing address:
  • Phone: 724-325-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001549E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: