MEDICARE: LOU PT

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	:	1558141770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOU PT

Provider Business Mailing Address
First Line	:	PO BOX 241
Second Line	:
City	:	POTTERSVILLE
State	:	NJ
Zip	:	07979-0241
Country	:	US
Telephone Number	:	908-963-3690
Fax Number	:

Provider Business Practice Location Address
First Line	:	1386 US HIGHWAY 22 STE 10
Second Line	:
City	:	LEBANON
State	:	NJ
Zip	:	08833-2205
Country	:	US
Telephone Number	:	908-963-3690
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOUIS F DIGIOVINE
Credential	:	PT
Telephone Number	:	908-963-3690

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/04/2023

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Directions to “LOU PT ” Practice Location

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