Healthcare Provider Details

I. General information

NPI: 1255430799
Provider Name (Legal Business Name): WALTER RICHARD GARCIA PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 FREEPORT RD 200 BLGD SUITE 4000
PITTSBURGH PA
15215-3301
US

IV. Provider business mailing address

1040 STRATMORE AVE
PITTSBURGH PA
15205-2413
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-5010
  • Fax: 412-784-5147
Mailing address:
  • Phone: 412-928-0864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT000736E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: