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General NPI Number Information
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NPI Number | 1396380150
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Entity Type | Organization
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Legal Business Name | SFAS PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 11/14/2019
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Provider Practice Location Address
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Address Line | 347A OLD CURRY HOLLOW RD
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City | PITTSBURGH
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State | PA
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Zip | 15236-4608
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Country | US
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Telephone | 412-653-7970
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 MCELHENY RD
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City | SOUTH PARK
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State | PA
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Zip | 15129-8986
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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 | PHYSICAL THERAPIST
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Name | JACOB WIETHOLDER
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Credential |
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Telephone | 412-653-7970
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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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