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General NPI Number Information
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NPI Number | 1174921829
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 12/11/2014
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Provider Practice Location Address
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Address Line | 2083 W PENN PIKE
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City | ANDREAS
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State | PA
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Zip | 18211-3259
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Country | US
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Telephone | 570-386-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 2083 W PENN PIKE
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City | ANDREAS
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State | PA
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Zip | 18211-3259
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC COORDINATOR
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Name | ROBERT MURPHY
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Credential |
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Telephone | 570-386-3399
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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 | PT12796L
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License Number State | PA
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