MEDICARE: MR. PETER MICHAEL HOUDEK MS, LAT, ATC, CES

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	2255A2300X	Athletic Trainer	RT004946	PA

General Provider Information

NPI Number	:	1336505841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PETER MICHAEL HOUDEK MS, LAT, ATC, CES

Provider Business Mailing Address
First Line	:	208 JACOBS CT
Second Line	:
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-3376
Country	:	US
Telephone Number	:	215-380-2208
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 W ALLEGHENY RD
Second Line	:
City	:	IMPERIAL
State	:	PA
Zip	:	15126-9770
Country	:	US
Telephone Number	:	215-380-2208
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2016
Last Update Date	:	09/16/2020

Similar Medicare Providers

1063405645 — MR. DAVID G. MCBAIN LAT, ATC, CAA
Practice Location Address:

205 W ALLEGHENY RD
IMPERIAL, PA
15126-9770

Practice Phone: 724-695-5246
Practice Fax: 724-695-1546

1699715433 — WEST ALLEGHENY SCHOOL DISTRICT
Practice Location Address:

207 W ALLEGHENY RD , BOX 55
IMPERIAL, PA
15126-9770

Practice Phone: 412-695-3422
Practice Fax: 412-695-3788

1174406383 — PATRICIA RAVEN MONTAGUE LSW
Practice Location Address:

207 W ALLEGHENY RD
IMPERIAL, PA
15126-9770

Practice Phone: 724-695-8979
Practice Fax:

1164957775 — ANGEL FAZIO
Practice Location Address:

307 WALDEN WAY
IMPERIAL, PA
15126-9639

Practice Phone: 724-263-3920
Practice Fax:

1528334679 — EMILIE STEWART
Practice Location Address:

220 BRIAR PATH
IMPERIAL, PA
15126-9686

Practice Phone: 412-292-9122
Practice Fax:

1922005982 — TYLER MEDICAL SUPPLIES, INC.
Practice Location Address:

120 W ALLEGHENY RD STE 3
IMPERIAL, PA
15126-9788

Practice Phone: 724-695-7274
Practice Fax: 724-695-7815

Directions to “ MR. PETER MICHAEL HOUDEK MS, LAT, ATC, CES” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.