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NPI Code Detail

MEDICARE: MR. DENNIS C JAVENS PT, SCS, ATC

MEDICARE: MR. DENNIS C JAVENS PT, SCS, ATC
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 TherapistPTO10812LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679542906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS C JAVENS PT, SCS, ATC
Provider Business Mailing Address
First Line : 1005 CAMPUS CIR
Second Line :
City : HERMITAGE
State : PA
Zip : 16148-7901
Country : US
Telephone Number : 724-346-1529
Fax Number : 724-346-1498
Provider Business Practice Location Address
First Line : 1005 CAMPUS CIR
Second Line :
City : HERMITAGE
State : PA
Zip : 16148-7901
Country : US
Telephone Number : 724-346-1529
Fax Number : 724-346-1498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 12/05/2012

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