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NPI Code Detail

MEDICARE: DAVID PHYSICAL THERAPY AND SPORTS MEDICINE CENTER INC.

MEDICARE: DAVID PHYSICAL THERAPY AND SPORTS MEDICINE CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT006491LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2199055OTHERPABLUE SHIELD GRP NUMBER

General Provider Information

NPI Number : 1003846825
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID PHYSICAL THERAPY AND SPORTS MEDICINE CENTER INC.
Provider Business Mailing Address
First Line : 433 CASTLE SHANNON BLVD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15234-1405
Country : US
Telephone Number : 412-344-9044
Fax Number :
Provider Business Practice Location Address
First Line : 433 CASTLE SHANNON BLVD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15234-1405
Country : US
Telephone Number : 412-344-9044
Fax Number :
Authorized Official
Title or Position : OWNER/THERAPIST
Name : DR. JOSEPH M DAVID
Credential : DPT, MS, PT,OCS,CSCS
Telephone Number : 412-344-9044
Provider Enumeration Date : 07/04/2006
Last Update Date : 02/24/2017

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15234-1405
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1114062825 — MR. BRYAN RUSSELL ORENCHUK MS, ATC
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Directions to “DAVID PHYSICAL THERAPY AND SPORTS MEDICINE CENTER INC. ” Practice Location

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