MEDICARE: MR. JAMES PATRICK BRIDGES MS, 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
1	174400000X	Specialist	RT003123	PA

General Provider Information

NPI Number	:	1699743880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES PATRICK BRIDGES MS, ATC

Provider Business Mailing Address
First Line	:	904 UPSTON AVE
Second Line	:
City	:	PORT VUE
State	:	PA
Zip	:	15133-4038
Country	:	US
Telephone Number	:	412-849-2348
Fax Number	:

Provider Business Practice Location Address
First Line	:	904 UPSTON AVE
Second Line	:
City	:	PORT VUE
State	:	PA
Zip	:	15133-4038
Country	:	US
Telephone Number	:	412-849-2348
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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