MEDICARE: WEST PENN PHYSICAL THERAPY

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1407830920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PENN PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	911 LIGONIER ST
Second Line	:
City	:	LATROBE
State	:	PA
Zip	:	15650-1805
Country	:	US
Telephone Number	:	724-537-9577
Fax Number	:	724-537-0195

Provider Business Practice Location Address
First Line	:	911 LIGONIER ST
Second Line	:	SUITE 001
City	:	LATROBE
State	:	PA
Zip	:	15650-1805
Country	:	US
Telephone Number	:	724-537-9577
Fax Number	:	724-537-0195

Authorized Official
Title or Position	:	PRESIDENT/PHYSICAL THERAPIST
Name	:	PAUL IMBROGNO
Credential	:	PT
Telephone Number	:	724-537-9577

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/09/2008

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911 LIGONIER ST , STE 102
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1972581734 — STEVEN W SELIP MD
Practice Location Address:

911 LIGONIER ST , SUITE 101
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Practice Location Address:

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1326090242 — CATHLEEN MOSSO FERLIN OTR/L
Practice Location Address:

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Practice Fax:

Directions to “WEST PENN PHYSICAL THERAPY ” Practice Location

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