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General NPI Number Information
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NPI Number | 1295271625
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Entity Type | Organization
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Legal Business Name | SPORTS MUSCLE FITNESS AND THERAPY
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 6331 WEST RIDGE RD
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City | ERIE
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State | PA
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Zip | 16506
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Country | US
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Telephone | 724-809-1551
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Fax |
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Provider Business Mailing Address
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Address Line | 6028 SWANVILLE RD APT 1A
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City | ERIE
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State | PA
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Zip | 16506-1160
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Country | US
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Telephone | 724-809-1551
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | JANANN M TURNER
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Credential | PT
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Telephone | 724-809-1551
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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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