Healthcare Provider Details

I. General information

NPI: 1083924989
Provider Name (Legal Business Name): COMPASS THERAPEUTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3332 PLANK RD
NEW CASTLE PA
16105-1027
US

IV. Provider business mailing address

3332 PLANK RD
NEW CASTLE PA
16105-1027
US

V. Phone/Fax

Practice location:
  • Phone: 724-654-4457
  • Fax: 724-654-2909
Mailing address:
  • Phone: 724-654-4457
  • Fax: 724-654-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016349
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC009189
License Number StatePA

VIII. Authorized Official

Name: MR. DONALD EDWARD WILT
Title or Position: CEO
Credential: PT
Phone: 814-330-4603