Healthcare Provider Details

I. General information

NPI: 1639138043
Provider Name (Legal Business Name): FIT FOR PLAY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 SANDY DR STE A
STATE COLLEGE PA
16803
US

IV. Provider business mailing address

2160 SANDY DR STE A
STATE COLLEGE PA
16803
US

V. Phone/Fax

Practice location:
  • Phone: 814-861-8122
  • Fax: 814-861-4292
Mailing address:
  • Phone: 814-861-8122
  • Fax: 814-861-4292

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: MR. JAMES P BENNETT
Title or Position: PHYSICAL THERAPIST/OWNER/PRESIDENT
Credential: MPT
Phone: 814-861-8122