MEDICARE: DRAYER PHYSICAL THERAPY INSTITUTE 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	:	1790960805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRAYER PHYSICAL THERAPY INSTITUTE LLC

Provider Business Mailing Address
First Line	:	781 FAR HILLS DR
Second Line	:	SUITE 400
City	:	NEW FREEDOM
State	:	PA
Zip	:	17349-8447
Country	:	US
Telephone Number	:	717-235-9890
Fax Number	:	717-235-9894

Provider Business Practice Location Address
First Line	:	781 FAR HILLS DR
Second Line	:	SUITE 400
City	:	NEW FREEDOM
State	:	PA
Zip	:	17349-8447
Country	:	US
Telephone Number	:	717-235-9890
Fax Number	:	717-235-9894

Authorized Official
Title or Position	:	CEO
Name	:	LUKE A DRAYER
Credential	:	PT
Telephone Number	:	717-220-2100

Provider Enumeration Date	:	01/08/2008
Last Update Date	:	05/12/2008

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