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General NPI Number Information
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NPI Number | 1518778612
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Entity Type | Organization
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Legal Business Name | T3 REHAB AND PERFORMANCE LLC TRENTON WOOLCOCK SOLE MBR
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 396 E 2ND AVE
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City | WILLIAMSPORT
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State | PA
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Zip | 17702-7409
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Country | US
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Telephone | 570-419-3289
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Fax |
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Provider Business Mailing Address
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Address Line | 138 LINVIC DR
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City | MUNCY
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State | PA
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Zip | 17756-8806
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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 | OWNER/PHYSICAL THERAPIST
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Name | TRENTON WOOLCOCK
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Credential |
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Telephone | 570-419-3289
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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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