Healthcare Provider Details

I. General information

NPI: 1255403382
Provider Name (Legal Business Name): SPRINT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N WASHINGTON AVE SUITE 703
SCRANTON PA
18503
US

IV. Provider business mailing address

327 N WASHINGTON AVE SUITE 703
SCRANTON PA
18503
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-1570
  • Fax: 570-346-1708
Mailing address:
  • Phone: 570-346-1570
  • Fax: 570-346-1708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: KIM ANN WOLFEL
Title or Position: CONTROLLER
Credential: CPA
Phone: 570-346-1570