MEDICARE: ORLOSKI PHYSICAL THERAPY LLC

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	:	1578342853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLOSKI PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	359 LAKE RD
Second Line	:
City	:	MOUNTAIN TOP
State	:	PA
Zip	:	18707-1756
Country	:	US
Telephone Number	:	570-417-0305
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 LAKE RD
Second Line	:
City	:	MOUNTAIN TOP
State	:	PA
Zip	:	18707-1756
Country	:	US
Telephone Number	:	570-417-0305
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JEFFREY ORLOSKI
Credential	:	DPT
Telephone Number	:	570-417-0305

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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