Healthcare Provider Details

I. General information

NPI: 1609835651
Provider Name (Legal Business Name): BETH A. CARR PT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 WATER ST
NORTHUMBERLAND PA
17857-1243
US

IV. Provider business mailing address

PO BOX 64 845 WATER STREET
NORTHUMBERLAND PA
17857-0064
US

V. Phone/Fax

Practice location:
  • Phone: 570-473-3912
  • Fax: 540-473-8731
Mailing address:
  • Phone: 570-473-3912
  • Fax: 540-473-8731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY C COMFORT
Title or Position: OFFICE MANAGER
Credential:
Phone: 570-473-3912