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General NPI Number Information
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NPI Number | 1942354402
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Entity Type | Organization
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Legal Business Name | PACE PHYSICAL THERAPY
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 MEMORIAL HWY
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City | DALLAS
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State | PA
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Zip | 18612-1240
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Country | US
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Telephone | 570-675-8151
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Fax |
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Provider Business Mailing Address
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Address Line | 201 MEMORIAL HWY
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City | DALLAS
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State | PA
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Zip | 18612-1240
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Country | US
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Telephone | 570-675-8151
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Fax |
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Authorized Official
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Title or Position | OWNER-DIRECTOR
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Name | JEFFREY GEORGE PACE
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Credential | L.P.T.
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Telephone | 570-675-8151
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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 | PT005230L
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License Number State | PA
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