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General NPI Number Information
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NPI Number | 1144577750
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Entity Type | Organization
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Legal Business Name | PENN NEUROMUSCULAR DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 81 HILLCREST DR STE 1300
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City | PUNXSUTAWNEY
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State | PA
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Zip | 15767-2605
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Country | US
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Telephone | 724-801-8894
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Fax | 724-465-6032
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Provider Business Mailing Address
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Address Line | 9 N 7TH ST 2ND FLOOR, TOWNPLACE VICTORIA
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City | INDIANA
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State | PA
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Zip | 15701-1880
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Country | US
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Telephone | 724-801-8894
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Fax | 724-465-6032
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS W. ZAUCHA
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Credential |
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Telephone | 724-801-8894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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