Healthcare Provider Details
I. General information
NPI: 1962715359
Provider Name (Legal Business Name): ATLAS THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2010
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3075 ENTERPRISE DRIVE SUITE 200
STATE COLLEGE PA
16801
US
IV. Provider business mailing address
3075 ENTERPRISE DRIVE SUITE 200
STATE COLLEGE PA
16801
US
V. Phone/Fax
- Phone: 814-308-8482
- Fax: 814-308-8449
- Phone: 814-308-8482
- Fax: 814-308-8449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| 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: MR.
JUSTIN
W
KURPEIKIS
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 724-612-9906