MEDICARE: PHYSIOTHERAPY ASSOCIATES 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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1285710673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	665 PHILADELPHIA ST
Second Line	:	STE 200
City	:	INDIANA
State	:	PA
Zip	:	15701-3941
Country	:	US
Telephone Number	:	724-465-3496
Fax Number	:	215-413-4682

Provider Business Practice Location Address
First Line	:	6501 PEAKE RD
Second Line	:	BDLG 100
City	:	MACON
State	:	GA
Zip	:	31210-8042
Country	:	US
Telephone Number	:	478-757-1667
Fax Number	:	478-476-0935

Authorized Official
Title or Position	:	CHIEF COMPLIANCE OFFICER
Name	:	MRS. JAYNE FLECK POOL
Credential	:
Telephone Number	:	469-467-8705

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	06/17/2009

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