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NPI Code Detail

MEDICARE: COLENE CLAYBORNE LPT

MEDICARE: COLENE CLAYBORNE LPT
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 TherapistPT017034PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11634362OTHERPAHIGHMARK

General Provider Information

NPI Number : 1427060466
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLENE CLAYBORNE LPT
Provider Business Mailing Address
First Line : 3600 GRANT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-2630
Country : US
Telephone Number : 215-677-0400
Fax Number : 215-971-1837
Provider Business Practice Location Address
First Line : 3600 GRANT AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19114-2630
Country : US
Telephone Number : 215-677-0400
Fax Number : 215-971-1837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 10/15/2007

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Practice Location Address:
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Practice Location Address:
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1861891020 — KATHLEEN P TARPEY PT, DPT
Practice Location Address:
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Directions to “ COLENE CLAYBORNE LPT” Practice Location

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