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General NPI Number Information
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NPI Number | 1023011186
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Entity Type | Organization
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Legal Business Name | SOSAR PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 649 S GARFIELD AVE
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City | FRACKVILLE
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State | PA
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Zip | 17931-2427
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Country | US
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Telephone | 570-874-2125
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Fax | 570-874-4019
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Provider Business Mailing Address
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Address Line | 649 S GARFIELD AVE
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City | FRACKVILLE
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State | PA
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Zip | 17931-2427
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Country | US
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Telephone | 570-874-2125
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Fax | 570-874-4019
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | REGINA A. CONSTANTINE
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Credential |
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Telephone | 570-874-2125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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