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General NPI Number Information
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NPI Number | 1083663595
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Entity Type | Organization
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Legal Business Name | DIGITAL REHABILITATION ASSOCIATES INC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 911 LIGONIER ST SUITE 003
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City | LATROBE
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State | PA
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Zip | 15650-1805
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Country | US
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Telephone | 724-537-9588
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 857
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City | LATROBE
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State | PA
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Zip | 15650-0857
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Country | US
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Telephone | 724-537-9588
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER/THERAPIST
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Name | MS. ELAINE C TESLOVICH
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Credential | OTR
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Telephone | 724-537-9588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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