MEDICARE: MRS. ANN ELIZABETH REPPERMUND 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	225100000X	Physical Therapist	PT017200	PA

General Provider Information

NPI Number	:	1740243583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN ELIZABETH REPPERMUND PT

Provider Business Mailing Address
First Line	:	4810 WOODLAKE DR
Second Line	:
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-1020
Country	:	US
Telephone Number	:	724-444-5359
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 DELAFIELD RD
Second Line	:	132Y-U
City	:	PITTSBURGH
State	:	PA
Zip	:	15215-1802
Country	:	US
Telephone Number	:	412-822-2111
Fax Number	:

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	03/18/2013

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