Healthcare Provider Details

I. General information

NPI: 1730314410
Provider Name (Legal Business Name): ONE TO ONE REHABILITATION AND AQUITICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2009
Last Update Date: 05/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4092 WAMPUM RD
NEW CASTLE PA
16102-3460
US

IV. Provider business mailing address

4092 WAMPUM RD
NEW CASTLE PA
16102-3460
US

V. Phone/Fax

Practice location:
  • Phone: 724-971-1021
  • Fax: 724-498-4333
Mailing address:
  • Phone: 724-971-1021
  • Fax: 724-498-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM JOSEPH SHUTTLEWORTH
Title or Position: PHYSICAL THERAPIST
Credential: MS. PT
Phone: 724-971-1021