Healthcare Provider Details

I. General information

NPI: 1336198050
Provider Name (Legal Business Name): DOUGLAS ALLEN HILLIARD RKT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080A SAXONBURG BLVD
SAXONBURG PA
16056
US

IV. Provider business mailing address

145 HANNASTOWN RD
BUTLER PA
16002-9027
US

V. Phone/Fax

Practice location:
  • Phone: 724-265-1600
  • Fax:
Mailing address:
  • Phone: 724-352-1569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: