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General NPI Number Information
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NPI Number | 1649600982
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Entity Type | Organization
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Legal Business Name | ADVANCE WELLNESS & EDUCATION CENTER,LLC
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Dates
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Enumeration Date | 11/22/2013
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Last Update Date | 04/12/2014
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Provider Practice Location Address
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Address Line | 105 S PIKE RD SUITE 200
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City | SARVER
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State | PA
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Zip | 16055-9283
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Country | US
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Telephone | 724-272-3844
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Fax |
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Provider Business Mailing Address
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Address Line | 222 MOOREHEAD RD
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City | SARVER
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State | PA
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Zip | 16055-8670
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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 | REBECCA TRAGGIAI
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Credential | P.T.
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Telephone | 724-272-3844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL007570
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT007479L
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License Number State | PA
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