MEDICARE: PHYSIOTHERAPY ASSOCIATES INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R93	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1679592703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	665 PHILADELPHIA ST
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3941
Country	:	US
Telephone Number	:	724-465-3496
Fax Number	:	215-413-4682

Provider Business Practice Location Address
First Line	:	1151 BLACKWOOD AVE STE 170
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4523
Country	:	US
Telephone Number	:	407-295-8890
Fax Number	:

Authorized Official
Title or Position	:	CHIEF COMPLIANCE OFFICER
Name	:	MRS. JAYNE FLECK POOL
Credential	:
Telephone Number	:	469-467-8705

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	06/16/2009

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Directions to “PHYSIOTHERAPY ASSOCIATES INC ” Practice Location

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