Healthcare Provider Details

I. General information

NPI: 1982495255
Provider Name (Legal Business Name): ARMORY PERFORMANCE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 DAVIS ST
SCRANTON PA
18505-3507
US

IV. Provider business mailing address

2429 HICKORY LN
RANSOM TWP PA
18411-9636
US

V. Phone/Fax

Practice location:
  • Phone: 845-467-5386
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. HEIDI PETERS
Title or Position: OWNER
Credential: DAT, LAT, ATC
Phone: 845-467-5386